Clinical characteristics were retrospectively analyzed in a patient with parathyroid crisis as the main symptoms of parathyroid adenoma and asymptomatic pheochromocytoma.This analysis was aimed to implement specific diagnosis and treatment and to accumulate experience in managing these diseases.

Objective To investigate the correlation between serum levels of 25 hydroxyvitamin D and immunoglobulin E(IgE)in adults.Methods There were 1 969 participants over the age of 19 were enrolled in this studied,serum total IgE,dermatophagoides farinae(Df)-specific IgE,and serum 25(OH)D levels were analyzed.Other variables included sex,age,body mass index,smoking history,and economic status were collected.Adjusted regression analysis was used to examine the independent association of 25(OH)D with serum IgE levels.Results The average serum 25(OH)D level of 1 969 patients was(18.0±6.5)μg/L,the prevalence of asthma,allergic rhinitis,and atopic dermatitis were 15.2％(299/1 969),2.8％(63/1 969)and 3.0％(68/1 969)respectively,however,there was no significant difference in serum 25(OH)D levels in patients with allergic rhinitis.All subjects were divided into four groups according to the serum 25(OH)D level: Q1:less than and equal to 13.4 μg/L,Q2:more then and equal to 13.4 μg/L but less then and equal to 17.0 μg/L,Q3: more then and equal to 17.0 μg/L but less then and equal to 21.7 μg/L,and Q4: more than and equal to 21.8 μg/L.The median TIgE level increased with higher quartiles in the Kruskal-Wallis test.The prevalence of Df in Q1,Q2,Q3,Q4 group were 39.8％,33.2％,38.7％and 43.1％,respectively.Linear regression analysis indicated that 25(OH)D levels were positively correlated with lgTIgE(regression coefficient:0.011,95％CI 0.001-0.021),25(OH)D in male patients with dust mite allergy was positively correlated with lgTIgE(regression coefficient:0.026,95％CI 0.010-0.043).There was no significant correlation between 25(OH)D and lgTIgE in the other groups.Conclusion Adult serum 25(OH)D levels is positively correlated with total IgE levels.

OBJECTIVETo discuss feasibility and clinical effects of minimally invasive percutaneous plate osteosynthesis in treating acetabulum anterior column fracture with intact true pelvic brim.

METHODSFrom May 2013 to December 2015, 8 patients with acetabulum anterior column fracture with intact true pelvic brim were reviewed retrospectively. According to Judet-Letournel classification, all were simple unstable acetabulum anterior column fracture. Among them, there were 5 males and 3 females with an average age of 42.8 years old ranging from 22 to 63. The injury was caused by crush in 4 cases, smash of heavy object in 3 cases, and falling down in 1 case. The time from injury to operation was ranged from 5 to 19 days with an average of 9.5 days. Preoperative CT showed high anterior column fracture of acetabulum with intact true pelvic brim, the fracture separation was less than 1 cm. All the patients were treated with closed reduction and minimally invasive percutaneous plate osteosynthesis. The quality of fracture reduction, operation time, blood loss, fracture healing time, hip function and postoperative complications were observed and recorded.

RESULTSAll patients were followed up from 10 to 19 months with an average of 14.5 months. The quality of reduction was classified as anatomical in 4 patients, imperfect in 3, poor in 1 by Matta's score system. The operation time was 30 to 80 min, averaged 51.3 min;the blood loss was 50 to 120 ml, averaged 86.2 ml; fracture healing time was 10 to 19 weeks, averaged 13.3 weeks. At the latest follow-up, the hip function was evaluated by Merle D'Aubigne scoring system, 5 cases got excellent results, 2 cases in good, and 1 case in fair. No vascular nerve injury, wound infection, bleeding, deep vein thrombosis and other complications occurred in 8 patients.

CONCLUSIONSMinimally invasive percutaneous plate osteosynthesis in treating acetabulum anterior column fracture with intact true pelvic brim has advantages of less trauma, less bleeding, quick recovery and good curative effect, and it is a good surgical procedures for acetabulum anterior column fracture.

In patient with primary biliary cirrhosis,the metabolism of calcium and vitamin D could be affected and osteomalacia and secondary hyperparathyroidism might occurr.Besides,hypoalbuminemia may mask the real level of serum calcium and thus lead to misdiagnosis of coexisting parathyroid adenoma.Therefore,a rare case of parathyroid adenoma associated with primary biliary cirrhosis was herewith presented to call attention to the effect of hypoalbuminemia on serum calcium.

It is an important safeguard to realize TCM renovation,raise medical levels and fulfill TCM modernization by elevating information diathesis of TCM personnel.This paper introduced the contents of information diathesis,discussed the current situation of TCM person information diathesis and the importance of elevating their information diathesis.By different kinds of training,how to raise the information awareness,information acquisition ability and information morality of TCM information personnel were further expounded.

OBJECTIVE To analyze the damage range and objective evaluate the vestibular function impairment in patients with sudden deafness at the same time of cochlea damage. To explore the difference of vestibular function damage in patients with sudden deafness with different hearing loss curve types. METHODS Sixty patients with unilateral sudden deafness and vertigo who were hospitalized in our department from August 2016 to August 2018 were selected as experimental group. There were 11 cases of low frequency descending type, 15 cases of flat descending type, 18 cases of high frequency descending type and 16 cases of total deafness type. Sixty healthy volunteer as control group. Two groups of patients underwent caloric test, ocular vestibular evoked myogenic potential(oVEMP), cervical vestibular evoked myogenic potential(cVEMP) and video head impulse test(vHIT). RESULTS The abnormal positive rate of caloric test, oVEMP and cVEMP in the control group was 10.3％, 26.7％, 16.7％ respectively. The abnormal positive rate of caloric test, oVEMP and cVEMP in the experimental group was 68.3％, 60.3％, 43.7％ respectively. The difference between the two groups is statistically significant. The abnormal positive rate of vHIT in the control group was 13.3％. The abnormal positive rate of vHIT in the experimental group was 51.6％. The difference between the two groups is statistically significant. The positive rate of vestibular dysfunction in patients with total deafness and ascending type was higher than that of flat type and descending type, but there was no significant difference between f lat type and descending type. CONCLUSION Patients with sudden deafness may be accompanied by impaired cochlea and vestibular function in different ranges. The vestibular function of patients with sudden deafness can be evaluated effectively by combined caloric test, oVemp, cVEMP and vHIT. The incidence of vestibular dysfunction in patients with total deafness and ascending sudden deafness was higher than that of flat type and descending type. And there was no significant difference in the incidence of vestibular function injury between flat type and descending type patients.

Objective:To establish an HPLC method for the determination of paraquat in human serum.Methods:The analytical column was a Kromasil C18column (200mm×4.6mm,5μm).The mobile phase was a mixture of acetonitrile and water ( containing 0.03 mol·L-1sodium heptanesulfonate and 0.24 mol·L-1phosphoric acid) (3 :97,pH was adjusted to 2.0 by triethylamine),the detection wavelength was set at 258 nm,the column temperature was 25℃,the injection volume was 20 μl,and the flow rate was 0.8 ml·min-1.Results:The calibration curve of paraquat was linear within the range of 0.106-10.6 mg·L-1( r =0.999 3),and the lower limit of detection was 0.065 mg·L-1. The absolute recovery of paraquat at low,medium and high concentration was more than 89.4%,and the method recovery was more than 94.4%. The intra-day RSDs were 0.12%-1.74%,and the inter-day RSDs were 0.44%-2.89%.Conclusion:The method is simple,quick,accurate,sensitive and specific,and can be used for detecting paraquat con-centration in human serum.

Objective:To preliminarily observe the clinical efficacy of microwave hyperthermia combined with intensity-modulated radiotherapy (IMRT) and chemotherapy for patients with locally advanced gastric cancer.Methods:Forty patients who could not been operated or refused operation were enrolled in this clinical trial, who were confirmed as locally advanced proximal or distal gastric cancer by gastroscopy pathology and imaging. Radiotherapy was delivered by IMRT technology for 5 times per week with a total dose of 46 to 56 Gy (median dose of 50 Gy) in 25 to 28 fractions. Synchronous hyperthermia was given at 42 to 44℃ twice a week, 45 min/time. S-1 or capecitabine-based synchronous chemotherapy was performed, d1-14/3 weeks. The symptom remission rate, adverse reactions, objective remission rate (complete and partial remission) and survival were observed.Results:A total of 40 patients, aged between 56 and 83 years (median age of 71 years), were enrolled in this study. The male-to-female ratio was 7: 1. Among them, 38 cases (95%) showed symptom remission. The most common adverse reactions were grade 1-2 gastrointestinal reactions and leukopenia. The objective remission rate was 87.5%, the 2-year progression-free survival and overall survival rates were 68.6% and 70.5%, respectively.Conclusion:Preliminary findings demonstrate that microwave hyperthermia combined with chemoradiotherapy achieve satisfactory outcomes and yield tolerable toxicity in patients with locally advanced gastric cancer.

This study aimed to investigate the influence of anti-cross-reactive carbohydrate determinant IgE antibodies (anti-CCD IgE) on the detection of allergen-specific IgE (sIgE) antibodies, as well as the application value of anti-CCD IgE adsorbents in detecting allergen sIgE. In this cross-sectional study, a total of 2 636 test samples from patients who received treatment in West China Hospital of Sichuan University and tested allergen sIgE using the western blot method from October 2020 to May 2021 were analyzed. In these samples, 709 samples tested postive of allergen sIgE. 46 stochastic venous serum samples that tested positive in both sIgE and anti-CCD IgE and 1 serum sample that tested positive in sIgE but negative in anti-CCD IgE were collected. These samples were processed by anti-CCD IgE adsorbents, followed by allergen sIgE detection. The difference between the two detection results before and after adsorption was analyzed. The allergen test results showed that the positive rate of anti-CCD IgE in samples was 2.6% (69/2 636) during the period of sample collection. After treatment with anti-CCD IgE adsorbents, the top three allergen-sIgE of the positive rate changed from tree combination 2 (willow/poplar/elm), common ragweed and peanut to dust mite combination, cockroach and crab. The positive anti-CCD IgE results of 46 samples all turned negative and the total positive sIgE antibody dropped by 62.8%; the positive rate of sIgE antibodies with the class result ≥2 significantly decreased after treatment with anti-CCD IgE adsorbents, especially the positive rate of common ragweed dropped by 96.2%. The results of positive samples showed that multiple sIgE antibodies declined by different ranges, involving up to 11 antibodies with a maximum decline of 4 classes. Strongly positive sIgE antibodies (the class result ≥4) also had a high conversion rate of negative (25.0%-100%). The positive sIgE antibodies in about 60% of the samples decreased by more than 2, and the sIgE antibodies in 17.4% of the samples turned completely negative. There was no change in the allergen sIgE detection results of the sample with negative anti-CCD IgE after treatment. In conclusion, sIgE antibodies including targeting common ragweed, humulus, tree combination 2 (willow/poplar/elm), etc. are susceptible to false positives caused by anti-CCD IgE. Treatment of samples with anti-CCD IgE adsorbents can significantly reduce the risk of false positives caused by anti-CCD IgE. It is necessary to pretreat samples that were anti-CCD IgE positive with anti-CCD IgE adsorbents, which can make laboratory results more accurate and provide a reference for diagnosis and prevention of allergic diseases.

This study aimed to investigate the influence of anti-cross-reactive carbohydrate determinant IgE antibodies (anti-CCD IgE) on the detection of allergen-specific IgE (sIgE) antibodies, as well as the application value of anti-CCD IgE adsorbents in detecting allergen sIgE. In this cross-sectional study, a total of 2 636 test samples from patients who received treatment in West China Hospital of Sichuan University and tested allergen sIgE using the western blot method from October 2020 to May 2021 were analyzed. In these samples, 709 samples tested postive of allergen sIgE. 46 stochastic venous serum samples that tested positive in both sIgE and anti-CCD IgE and 1 serum sample that tested positive in sIgE but negative in anti-CCD IgE were collected. These samples were processed by anti-CCD IgE adsorbents, followed by allergen sIgE detection. The difference between the two detection results before and after adsorption was analyzed. The allergen test results showed that the positive rate of anti-CCD IgE in samples was 2.6% (69/2 636) during the period of sample collection. After treatment with anti-CCD IgE adsorbents, the top three allergen-sIgE of the positive rate changed from tree combination 2 (willow/poplar/elm), common ragweed and peanut to dust mite combination, cockroach and crab. The positive anti-CCD IgE results of 46 samples all turned negative and the total positive sIgE antibody dropped by 62.8%; the positive rate of sIgE antibodies with the class result ≥2 significantly decreased after treatment with anti-CCD IgE adsorbents, especially the positive rate of common ragweed dropped by 96.2%. The results of positive samples showed that multiple sIgE antibodies declined by different ranges, involving up to 11 antibodies with a maximum decline of 4 classes. Strongly positive sIgE antibodies (the class result ≥4) also had a high conversion rate of negative (25.0%-100%). The positive sIgE antibodies in about 60% of the samples decreased by more than 2, and the sIgE antibodies in 17.4% of the samples turned completely negative. There was no change in the allergen sIgE detection results of the sample with negative anti-CCD IgE after treatment. In conclusion, sIgE antibodies including targeting common ragweed, humulus, tree combination 2 (willow/poplar/elm), etc. are susceptible to false positives caused by anti-CCD IgE. Treatment of samples with anti-CCD IgE adsorbents can significantly reduce the risk of false positives caused by anti-CCD IgE. It is necessary to pretreat samples that were anti-CCD IgE positive with anti-CCD IgE adsorbents, which can make laboratory results more accurate and provide a reference for diagnosis and prevention of allergic diseases.