Objective To estimate the effect of bacille calmette-guerin polysaccharide nucleic acid(BCG-PSN)on skin prick test(SPT)reactions,and to assess the clinical efficacy and therapeutic mechanism of BCG-PSN combined with mizolastine,in patients with chronic idiopathic urticaria.Methods A non-randomized,openlabel clinical trial was carried out.Totally,168 patients with chronic idiopathic urticaria were divided into 2 groups to be treated with mizolastine 10 mg once a day combined with BCG-PSN injection at a dose of 2 ml every other day(experiment group,n =85)or mizolastine 10 mg once a day only(control group,n =83).All the patients underwent SPT,and were evaluated by symptom score at the baseline and after 12 weeks of treatment.Statistical analysis was performed by using the SPSS 10.0 software,t test and Chi-square test were used to analyze the intra-and inter-group differences in symptom score reducing index(SSRI)and SPT results.Results After 12-week treatment,SSRI was significandy higher in the experiment group than in the control group(0.92 ± 0.33 vs.0.74 ± 0.35,t =2.39,P ＜ 0.05).In the experiment group,50 patients were cured,28 patients received a marked response,with a total response rate of 92.0％;meanwhile,32 patients were cured and 30 patients received a marked response in the control group with a total response rate of 74.6％;there was a significant difference in the total response rate between the experiment group and control group(x2 =5.62,P ＜ 0.05).The percentage of positive SPT to Dermatophagoides pteronyssinus and Dermatophagoides farinae was 24.7％ and 17.6％ respectively at the baseline,9.4％ and 5.9％ respectively after treatment,in the experiment group,24.1％ and 16.9％ respectively at the baseline,24.1％ and 15.7％ respectively after treatment,in the control group.Significant differences were observed in the percentage of positive SPT between the control group and experiment group after treatment(x2 =5.82,P ＜0.05),but not at the baseline.A statistical decrease in the percentage of positive SPT was induced by the combined therapy with BCG-PSN and mizolastine(x2 =4.56,P＜ 0.05),but not by mizolastine alone.Conclusions BCG-PSN combined with mizolastine appears superior to mizolastine alone in the treatment of chronic idiopathic urticaria,with a decrease in the percentage of positive SPT reactions and in the sensitivity to allergens.

Objective To analyze the clinical effects of internal radiation of iodine-125 seed implantation in the treatment of advanced pancreatic carcinoma.Methods 22 patients with unresectable and advanced pancreatic carcinoma were treated by the internal and interstitial radiation using iodine-125 seed implantation.Results Survival of 20 months was observed in 5 patients,10 ～ 20 months in 9 patients,2 ～10 months in 8,patients with an average of (13.47 ± 8.12) months.Among the 22 patients,complete response was obtained in 5 patients,partial response in 8 patients,no response in 7 paticnts,and the other showing PD.The response rate( CR + PR) was 59％.Conclusions Intra - operative internal radiation by iodine - 125 seed implantation does show some therapeutic effects for advanced pancreatic carcinoma.

Objective To evaluate the performance of an improved skin prick test in the screening for allergens.Methods A total of 475 patients with chronic urticaria who aged from 3 to 81 years were enrolled in this study,and classified into the control group (n =235) and research group (n =240).Traditional and improved skin prick test were conducted in the control and research group respectively.The allergen detection rate was compared between the two test methods.Results The allergen detection rate was 65.4％ and 67.2％ respectively for the improved and traditional skin prick test,respectively (P ＞ 0.05).House dust mites were the most common sensitizing agent.Conclusion The improved skin prick test can offer reliable evidence for chnical diagnosis with a relatively convenient and safe procedure.

Objective To investigate the therapeutic effect of total mesorectal excision(TME) for low rectal cancer.Methods One hundred nineteen patients with rectal cancer,located on an average within 8 cm of the anal verge,were included in the study.Fifty-four patients underwent traditional operation,and sixty-five patients underwent total mesorectal excision.Operation time,loss of blood at operation and local recurrence rates were compared between the two groups.Results The average operation time and blood loss were 118 minutes,and 100mL respectively in TME group,and they were 182 minutes,and 340 ml respectively in traditional operation group.There were significant differences between them(all P0.05).Conclusions In TME group,operation time was shorter,operative blood loss was less,and local recurrence rate was lower.TME should be applicated for patients with low rectal cancer.

Objective To analyze the emergency-event in patients with obstructive sleep apnea-hypopnea syndrome( OSAHS), and to discuss the risk factors and preliminary strategies for prevention of emergency-event. Method A total of 257 OSAHS patients in Zhejiang Provincial Peoples Hospital, were enrolled from January 2000 to December 2009 for the retrospective study. Demographics of patients include age, sex,height, weight, related diseases, AHI and LSaO2 before operation , the way of anesthesia and operation,when and how the emergency-events happened, the way to cure and the results. Risk facts of emergency-event were analyzed by using univariate analysis and multiple logistic regression analysis. Results Of the 257patients, the incidents of emergency-event was 7.3%. The independent risk factors of emergency-event were general anesthesia, multiple level surgery in one time, BMI and AHI. Performing CPAP treatment before operation had a beneficial effect to the avoidance of emergency-event. Conclusions Emergency-event are more common in severe OSAHS patients, especially when they were operated under general anesthesia and multiple level surgery in one time. Performing CPAP treatment before operation had a beneficial effect to the avoidance of emergency-event.

Objective To explore the protective effect of a small balloon on bifurcation lesions by applying a single stent treatment of coronary bifurcation lesions strategy. Methods Fifty patients with coronary bifurcation lesions were randomly divided into A group and B group( 25 cases for each group ). Patients in A group were treated with the pre-entry protection branch guide wire to complete the main branch balloon pre-dilation,stenting,while in B group were treated with the set aside the branches of a small balloon. The information of main branch balloon pre-dilation,stenting were recorded. The blood flow slowed down,the incidence of side branch occlusion or stent placement,and the incidence of postoperative 24 h troponin I( cTnI) levels were measured. Results Nine cases(36%)in A group occurred lower branch blood flow,which due to 4 cases(16% )with significantly narrow branch stenting,2 cases(8%)with complete occlusion. There were only 2 cases(8%)with decrease branching blood flow in B group,and the difference was significant(P=0. 041, 0. 022). The cases with higher cTnI after 24 h in A group were 11( 39%),significantly higher in group B (3(12 %);P =0. 027 ). Conclusion Compared with the traditional protection guidewire,the approach of setting aside a small balloon to protect important branch can effectively prevent important branch occlusion, branch involvement due to lower incidence of myocardial infarction.

Objective To determine the effects of trimetazidine (TMZ) on pathology and energy metabolism of myocardium in chronic renal failure(CRF) rats.Methods CRF models were built in Sprague-Dawley (SD) rats with 5/6 subtotal nephrectomy, and animals were randomyly divided into sham group, control group and three groups treated with different doses of TMZ (3 mg/kg,6 mg/kg or 9 mg/kg).TMZ was intragastrically administrated to CRF rats for 17 weeks, while physiologicalsalinewasusedascontrol. Transthoracicechocardiographywasperformedand myocardial morphosis was observed.Left ventricular weight/body weight(LVW/BW) and heart weight/body weight (HW/BW) were measured, and heart rate, and mean arterial pressure (MAP)were detected at the end of the study, while several parameters were detected, including urea nitrogen (BUN), creatinine(Scr), triphosaden(ATP), adenosine diphosphate(ADP), superoxide dismutase (SOD), malondialdehyde (MDA), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α).Results (l)Left ventricle end-systolic dimensions, anterior wall end-diastolic and end-systolic thicknesses, and posterior wall end-diastolic thickness were significantly lower in rats treated with either medium dose or high dose of TMZ, as compared with control group(P＜0.05).(2)LVW/BW and HW/BW in rats treated with either medium dose or high dose of TMZ were significantly lower than those in control group(P＜0.05). (3)Various pathological changes were observed in control group, such as irregular arrangement and hypertrophy of the cardiomyocytes, myocardial fibrosis,mitochondrial swelling, focal muscle fiber dissolution, etc.However, all these pathological changes were apparently ameliorated in TMZ-treated groups, while the beneficial effects of TMZ therapy were dose-dependent. (4)No difference was observed in heart rate among all the groups.Although no difference existed in all the CRF rats, concerning on the systolic/diastolic blood pressure and mean arterial pressure (P＞0.05), these parameters were elevated in CRF rats, as compared with sham-operated group(P＜0.01). (5)ATP and ADP in TMZ-treated rats were significantly higher as compared with control(P＜0.05), moreover, medium dose and high dose of TMZ were superior to low dose (P＜0.05).(6)SOD was significantly increased in TMZ-treated rats (P＜0.05), while IL-6,TNF-α and MDA were significantly decreased in medium dose and high dose of TMZ, as compared with control(P＜0.05).Conclusion TMZ may prevent myocardial fibrosis and left ventricular hypertrophy in chronic renal failure via ameliorating myocardial energy metabolism and alleviating inflammatory reaction and oxidative stress.

Objective: To study the relationship between vitamin A (VA) supplementation and the level of IgG antibody to measles strengthened vaccination. Method: Fifty-three school children aged 5-13 years were selected as the test group of VA supplementation, and fifty-two school children as the control group whose ages and sex matched with the test group. The test group was supplicd po the VA pills (2 500IU) at the same time with measles strengthened vaccination for one month. The level of serum VA was analyzed by HPLC. Measles antibody IgG was detected by ELISA. Results: One month after VA supplementation, sernm VA in test group was 376.5?74.2 ?g/L, showing statistical increase over before. The positive rates of measles antibody in the test group were increased from 69.8% to 100%, and the protective rate from 5.6% to 60.4%. The positive rates of measles antibody in the control group were increased from 71.2% to 100%, and the protective rates from 0% to 17.4%. The protective rate in the test group was statistically higher than the control. Conclusion: Simultaneous VA supplementation (especially for the children of VA deficiency) and measles strengthened vaccination contribute to the increase of measles antibody IgG in school children.

Abstract In April 2021, type Ⅰ vaccine-derived poliovirus (VDPV) was detected from two fecal samples of a male infant with acute flaccid paralysis (AFP) in Zhejiang Province when he was admitted to the Children's Hospital Affiliated to Fudan University in Shanghai, with 12 and 14 nucleotide mutations in the VP1 region, respectively. The case had a history of immunization with three doses of poliovirus vaccines, and grade Ⅲ proximal muscle strength and grade Ⅱ distal muscle strength of the right lower limb. After symptomatic treatment, the activity of the right lower limb and the muscle strength was significantly restored, thus he was discharged. VDPV was not detected from subsequent (the 8th to 12th) fecal samples of the case and fecal samples of close contacts. No similar cases were found in medical institutions in the county, surrounding areas, neighboring villages or towns. Since the case did not exhibit clinical symptoms of poliomyelitis caused by VDPV, poliomyelitis was excluded, and the case was diagnosed with hemophilia type A based on the epidemiological investigation, laboratory tests, and the history of poliomyelitis vaccination. This event involved cross-provincial (municipal) cooperation and was responsed promptly, preventing further spread of the virus. It suggested that the sensitivity of the AFP case surveillance system should be maintained, environmental monitoring methods should be increased, and the poliomyelitis vaccination should be promoted to prevent the spread of the virus.