Objective To explore the allergic status and allergen composition in children with acute Henoch-Schonlein Purpura in Wuxi by allergen detection, thereby to establish appropriate therapeutic strategies. Methods Two hundred and forty-six patients with Henoch-Schonlein Purpura in their acute phase were examined for serum concentrations of total IgE and specific IgE using Germany AllergyScreen system. Results The positive rate of allergen-specific serum IgE was 48.7% (120/246) ,of which,positive reactions to two or more than two allergens were found in 86 cases (34.9%) and that to one kind of allergen were found in 34 cases (13.8%)The positive rate of total serum IgE was 78.9% (194/246). In inhalation allergen group, positive reaction to allergen was found in 134 cases (54.5%). The most common allergen was dust mite/flour mites (19.1%) ,and came the next were house dust(17.1%) and Penicillium notatum/Alternaria alternata(10.2%). In food allergen group,positive reaction to allergen was found in 77 cases (31.3%). The most common allergen was fish (6.5%),and came the next were egg (5.7%) and mutton (5.3%). We found no significantly different allergen positive rates between inhalation allergens group and food allergens group (χ2 = 2.59, P ＞ 0.05). Conclusions The combined allergens attacks were more common in children patients with acute Henoch-Schonlein Purpura by serum allergen detection. Various types of the allergens are associated with the occurrence of acute Henoch-Schonlein Purpura. To reduce the harmness of allergens,it is necessary to avoid touching these allergens.

Objective: To investigate the self-care activities and their influencing factors among young and middle-aged patients with type 2 diabetes mellitus ( T2DM ), so as to provide the basis for the care management of T2DM. Methods: T2DM patients at ages of 18 to 59 years that were admitted to Department of Endocrinology, Hangzhou First People's Hospital Affiliated to Medical School of Zhejiang University were selected using the convenient sampling method from January to August 2021, and the demographic data were collected using questionnaires, including gender, age and educational levels. The self-care level was measured using the Summary of Diabetes Self-Care Activities ( SDSCA ) was used to assess self-management behaviors, and the social support level was evaluated using the Social Support Rating Scale ( SSRS ), while the coping modes were assessed using the Medical Coping Modes Questionnaire ( MCMQ ). Factors affecting the self-care activities were identified among young and middle-aged patients with T2DM using multivariable linear regression analysis. Results: The 342 respondents included 185 men ( 54.07% ) and 157 women (45.93% ), and had a mean age of ( 43.76±3.82 ) years. The total score of self-care activities was ( 94.22±18.74 ), and the overall scoring rate was 72.48%, including 63 cases with high scores ( 18.42% ), 208 cases with moderate scores ( 60.82% ) and 71 cases with low scores ( 20.76% ). Multivariable linear regression analysis identified gender ( women, β'=0.213 ), educational level ( high school/technical secondary school, β'=0.187; diploma and above, β'=0.411 ), household monthly income per capita (5 000 Yuan and higher, β'=0.390), course of disease ( >5 years, β'=0.340 ), history of receiving health education targeting diabetes ( β'=0.411 ), coping mode ( avoidance, β'=0.195; confronce, β'=0.367 ) and social support level ( general, β'=0.206; high, β'=0.383 ) as factors affecting self-care activities among young and middle-aged patients with T2DM. Conclusions The overall self-care activities at a moderate level among young and middle-aged patients with T2DM, which are associated with gender, educational level, economic income, course of disease, health education targeting diabetes, coping mode and social support level.

By using the image processing function and programming tomography,the following functions are realized: the contour line,edge line and gradation histogram of medical images are displayed;the selected regions of medical images are freely zoomed;the gray level of discretional regions is displayed using medical image processing tool and the distance of the given points is freely measured.

Objective To understand the status quo of the prevention and treatment of hepatitis B in rural area ,to analyze the shortages in prevention and treatment strategy ,to explore the corresponding prevention countermeasures and to provide the scientif‐ic basis .Methods The inhabitants were randomly sampled from 6 natural villages in the rural area of Zhangjiakou as the research subjects .The venous blood HBsAg and HBsAb were detected .The respondents were divided into 2 groups according to the distance of residence place from cities and towns .The distribution differences of HBsAg and HBsAb were compared among different age groups for analyzing the influence of age and public health conditions on the HBV control effects .Results The HBsAg positive rate averaged 5 .92% and the HbsAb positive rate averaged 33 .73% ,with the age increase ,the HBsAg positive rate showed the increas‐ing trend and the anti‐HBsAb showed the decreasing trend ;the anti‐HBsAb positive rate in the inhabitants aged under 15 years near town was higher than those far from town .Conclusion It is needed to increase the input and support intensity to the rural areas in the aspects of finance and manpower ,improve the public health conditions of the rural area with the planned immunity as the main thing ,enlarge the hepatitis B vaccine inoculation range ,strengthen the publicity of HBV harm ,prevention and treatment knowledge , increase the neonatal hepatitis B vaccine inoculation rate and the 24 h timely inoculation rate of hepatitis B vaccine ,accomplish the immune blocking in pregnant women with HBsAg positive ,and preventing the HBV communication during feeding process in in‐fants .

Objective To study the correlation between early cognitive function and severity of pain in elderly patients after operation. Methods Selective open abdominal operation was performed in 30 elderly patients admitted to our department from January 2009 to June 2009. Severity of pain was assessed using visual analogue scale ( VAS) and cognitive function was scored with Mini-Mental State Examination ( MMSE) ,animal fluency test ( AFT) and clock drawing test ( CDT) ,respectively,in 24 and 48 h after operation. Cognitive function of the patients was assessed from the view of neurophysiology. Pain was scored after operation with VAS. Variables were analyzed with the linear correlation analysis. Correlation between early cognitive function and severity of pain in elderly patients was observed after operation. Results No linear correlation was observed between scores on MMSE,VAS and AFT scales in 24 and 48 h after operation ( r = -0. 053,P = 0. 786; and r = -0. 052,P = 0. 783; and r = -0. 323,P = 0. 082; and r = -0. 038,P = 0. 841). A negative linear correlation was found between scores on CDT and VAS scales in 24 and 48 h after operation ( r = -0. 731,P =0. 000; and r = -0. 636,P = 0. 001). Conclusion Cognitive function including visual space structure function and implementing function in elderly patients after operation is correlated with the pain scores on VAS scale.

Objective To study the role of esophagogastric junction contractile index (EGJ-CI) in evaluating the function of anti-reflux barrier,and in differentiating patients with gastroesophageal reflux disease (GERD) from those with functional heartburn (FH).Methods A total of 115 patients presenting heartburn were enrolled in the study from January 2012 to June 2015.All subjects had completed Gerd-Q questionnaire and undergone gastroscopy,24-hour pH-impedance monitoring and esophageal high-resolution manometry.GERD patients were divided into as reflux esophagitis,acid-nonerosive reflux disease (NERD) and weakly acid-NERD groups.Patients with normal esophageal mucosa,normal acid exposure and negative proton pump inhibitor test were enrolled in FH group.EGJ-CI (mmHg · cm) as well as EGJ rest pressure and 4s integrated relaxation pressure (IRP 4s) were measured.Results Among the 115 patients,18 were reflux esophagitis [(49.0 ± 18.9) years,M ∶ F =10 ∶ 8],25 were acid-NERD [(48.7 ± 14.4) years,M∶F=13∶ 12],37 were weakly acid-NERD [(52.0 ±14.8) years,M∶F=15∶22] and 35 were FH [(53.6 ± 14.8),M∶ F =8∶27].No differences of Gerd-Q scores were noticed between the four groups.(1) Negative correlations were demonstrated between EGJ-CI and esophageal acid exposure time (r =-0.283,P =0.002),EGJ-CI and acid reflux events (r =-0.233,P =0.012),EGJ-CI and weakly acid reflux events (r =-0.213,P =0.022),EGJ-CI and non-acid reflux events (r =-0.200,P =0.032).(2)The value of EGJ-CI was significantly higher in FH patients than in the three subgroups of GERD(all P ＜ 0.01).EGJ rest pressure of FH group was higher than that of acid-NERD (P ＜ 0.01).IRP 4s in acid-NERD group was lower than that of FH and weakly acid-NERD (P ＜ 0.05).(3) The area under curve (AUC) of EGJ-CI was higher than that of EGJ-CIT,EGJ rest pressure or IRP 4s (0.686 vs 0.678,0.641 and 0.578).The cut-off value of EGJ-CI to differentiate GERD from FH was 9.74 mmHg · cm with sensitivity 82.86％ and specificity 51.52％.Conclusions The EGJ-CI values are negatively correlated with esophageal acid exposure time,weakly acid reflux events and non-acid reflux events.Thus it might be used as a metric to reflect the anti-reflux function of EGJ.According to the cut-off value of EGJ-CI 9.74 mmHg · cm,patients with GERD can be sensitively differentiated from patients with FH.

Objective To assess the anal and pelvic floor function in patients with rectocele (RC),and to afford the evidence for the treatments of RC.Methods Patients with functional constipation (FC) and healthy controls were consecutively enrolled,and all the subjects underwent defecography and anorectal manometry.According to defecography,the subjects were divided into four groups as no RC,mild RC,moderate RC and severe RC.The t-test,analysis of variance,rank sum test and Chi-square test were performed to compare the results of anorectal manometry between different RC groups in FC patients,and the results of anorectal manometry between moderate RC group in FC patients and control group with moderate RC were also compared.Results A total of 54 FC patients and 17 healthy controls were enrolled.No RC was found in all of male subjects.Of 48 female patients with FC,nine cases (18.8％) had no RC,seven (14.6％) had mild RC,18(37.5％) had moderate RC,and 14(29.2％) had severe RC.Three of the 12 female controls had no RC,one had mild RC,and eight had severe RC.Among all female patients with FC,the defecation rectal pressure in severe RC group ((34.4 ± 14.2) mmHg,1 mmHg=0.133 kPa) was significantly higher than of no RC group ((20.8 ± 13.1) mmHg,t=3.663,P=0.001),mild RC group ((19.1± 15.1) mmHg,t=3.719,P＜0.01) and moderateRC group ((25.6±16.3) mmHg,t=2.525,P=0.010).The left rectal pressure after defecation in mild RC group ((55.1 ± 19.7) mmHg) was significantly higher than that of moderate RC group ((43.3±17.6) mmHg,t=2.507,P=0.019) and severe RC group ((40.0±20.9) mmHg,t=2.619,P=0.006).The anal relax ratio in mild RC group (3.0％,0.5％ to 25.5％) was significantly lower than that of moderate RC group (19.5％,10.0％ to 29.0％,Z=-2.583,P=0.010) and severe RC group (22.0％,7.3％ to 54.5％,Z=-2.830,P=0.005).There were no significant differences in rectal and anal resting pressure,anal squeezing pressure,rectal sensory threshold and constituent ratio of manometry among four groups (all P＞0.05).The left rectal pressure after defecation in FC patients with moderate RC ((43.3 ± 17.6) mmHg) was significantly higher than that of controls with moderate RC ((26.3±20.8) mmHg,t=2.997,P＜0.01),and anal relax ratio was significantly lower than that of controls with moderateRC ((23.4±20.2)％ vs (55.2±16.3)％,t=-5.266,P=0.008).Conclusions RC is found in female and also found in individuals with normal defecation.FC patients with mild RC lack enough anal relax during defecation.However,defecation is relatively coordinate in FC patients with severe RC,which indicates that severe RC may be part of manifestation of pelvic floor relaxation.

Purpose To study the expression and interaction of iNOS and COX-2 in colorectal adenocarcinoma, as well as their relationship with the biological behaviors of colorectal adenocarcinoma.Methods Intestinal biopsy specimens of colorectal adenocarcinoma were collected in the 78 cases and 33 normal intestinal mucosal tissues.The expression of iNOS and COX-2 proteins was detected by immunohistochemical staining (SP method).Results The positive rates of iNOS and COX-2 protein was significantly higher in normal intestinal mucosa than that in colorectal adenocarcinoma (P<0.05).The expression of iNOS and COX-2 protien had significant relation with lymph node metastasis (P<0.05).The positive expression of iNOS and COX-2 in intestinal adenocarcinoma was related with TNM stage:the positive expression in patients with Ⅲ+Ⅳ stage was higher than that with Ⅰ+Ⅱstage (P<0.05). The expression of iNOS was closely correlated with COX-2 (P<0.05).Conclusions The overexpression of COX-2 and iNOS participates in the pathogenesis of colorectal carcinoma and is associated with lymph node metastasis and TNM stage of colorectal adenocarcinoma.The expression of iNOS is correlated with COX-2 in the cancer.

Objective To investigate the discrepancy of anorectal function in patients of Parkinson's disease (PD) with constipation and functional constipation (FC).Methods Fifteen consecutive male PD patients with constipation and 45 male FC patients were recruited for the study.All subjects underwent colonoscopy or barium enema in order to exclude organic colon diseases.Every patient underwent anorectal manometry and was categorized into subgroups of either dyssynergic defecation (F3a) or inadequate defecatory propulsion (F3b).Results The ages of PD with constipation and FC patients were (70 ± 11) and (68 ± 11) years old respectively.The rectal resting pressure in PD with constipation was higher than that in FC group without statistical significance [9.0 (4.0,15.0) mm Hg vs 6.0 (3.0,9.5) mm Hg,P=0.082,1 mm Hg =0.133 kPa].The anal resting pressure in PD group was not different from FC group [(51.2±17.2) mm Hg vs (59.7 ± 20.4) mm Hg,P =0.152].During anal squeezing,the maximal contraction pressure and area under the squeeze curve in PD with constipation group were both significantly lower than FC patients [maximal contraction pressure:(136.9 ± 43.8) mm Hg vs (183.0 ± 62.1) mm Hg,P=0.010; area under the squeeze curve:(823.5 ±635.7) mm Hg · s vs (1392.4± 939.9) mm Hg · s,P =0.033].During forced defecation,both of the defecation rectal pressure and defecation anal pressure in PD with constipation group were significantly lower than that of FC patients [22.0(15.0,30.0) vs42.0(31.0,55.0)mm Hg,P=0.000; and (46.3 ±23.3) vs (77.9 ±35.1) mm Hg,P =0.002].The proportions of F3a subtype were 10/15 and 46.7％ (21/45) in PD with constipation and FC patients respectively.There was no significant difference in the constituent ratio (P =0.120).Initial rectal sensory volumes were (91.3 ± 56.9) ml and (67.2 ± 38.9) ml in PD with constipation and FC patients respectively.Even both volumes were higher than the normal controls,there was no significant difference between the two groups (P =0.074).Conclusions Both PD with constipation and FC patients have abnormal anorectal motility and sensation comparing to the FC group,the parameters of anal contraction and defecation are significantly lower,F3b is dominant,and rectal sensory threshold is higher in PD with constipation patients.These parameters could possibly characterize the anorectal manometry for PD with constipation patients,which is helpful to understand the pathogenesis of PD and differentiate from other diseases.

Objective To observe the effect of reperfusion therapy on the prognosis of acute myocardial infarction (AMI) complicated by eardiogenic shock(CS)in reperfusion era.Methods 89 cases of AMI with CS were included with 57 male and 32 female.50 cases received conservative therapy and 39 cases reperfusion therapy.28 of the 39 cases had suecessflll reperfusion and 11 eases failed.18 patients had intra-aortic balloon pump (IABP) within 1 hour of CS,they constituted an early group;35 patients treated with IABP 1 hour after CS were of a late group.A group of 36 cases were not treated with IABP (no IABP group).Results The mortality of the early group with IABP Was significantly lower than that of the late and no IABP group(33.3% vs.74.2% vs.86.1%,P＜0.01).The mortality of the group with sucessful reperfusion was significantly lower than that of unsuccessful reperfusion and conservative no IABP group (42.8% vs.81.8% vs.84.0%,P＜0.01).logistic regression analysis showed that successful reperfusion therapy (OR 4.232,95% CI 1.407～12.730,P=0.01) and THE TIME of using IABP(OR 0.22.95% CI 0.063～0.764,P=0.017)were independent risk factors for death.Conclusion Early successful reperfusion and early institution of IABP were the most important therapeutic measures for reducing mortaliIv of AMI complicated by CS.