Objective To determine whether an environmental intervention tailored to each patient's allergic sensitization and environmental risk factors could improve asthma-related outcomes. Methods Irritant or allergen sensitivity determined by the patient's exposure history and confirmed with skin test. Patients were asked to record 2-week days without symptoms, days off-work(or school) and ?2-agonist puffs. Pulmonary function was also examined. Ninety-six asthmatics with atopic asthma (aged 16-78 years) were randomly assigned to a control group, an intervention group that received an educational handout monthly for 2 months. Asthmatics of both groups inhalded budesonide at a daily dose 200-800 ?g and ?2-agonist as needed. Environmental intervention lasted six months and included education and remediation for exposure to allergens. The control group had no special recommendations. Results The intervention group had more days without symptoms compared with the control group (13.4 vs.10.1days, P

China ; epidemiology ; Cross-Sectional Studies ; Female ; Health Status ; Humans ; Male ; Occupational Health

Objective To explore the incidence and risk factors of anti-tuberculosis (TB) drugs induced liver injury (ATDILI) and to discuss its impact on the treatment outcome of patients treated with first line anti-TB drugs.Methods Among the patients who received anti-TB treatment with directly-observed treatment strategy (DOTS),121 patients with ATDILI and 817 patients without ATDILI were included in this retrospective cohort study.Binary Logistic regression model was used to analyze the risk factors of ATDILI in univariate and multivariate analysis.The x2 test was used to compare the treatment success rates and drug resistant rates.Kaplan-Meier analysis and Log-rank test were used to compare the sputum smear/culture conversion rates and cavity closure rates.Results The incidence of ATDILI was 12.9％ (121/938) in this cohort.Multivariate Logistic regression showed that hepatitis B virus carrier with both hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) positive (OR=4.29,95％CI:2.15-8.58,P＜0.01),complicated with systemic lupus erythematosus (OR=3.34,95％CI:1.46-7.63,P=0.004),serum albumin ≤25 g/L (OR=3.14,95％CI:1.50-6.58,P=0.002) and alcoholism (OR=1.79,95％CI:1.14-2.82,P=0.012) were independent risk factors of ATDILI.The treatment failure rate in patients with ATDILI was significantly higher than that in patients without ATDILI (19.1％[24/121] vs8.0％[65/817],OR=2.86,95％CI:1.71-4.78,P＜0.01).The drug resistant rates of two groups were not significant different (4.1％[5/121] vs 1.7％[14/817],P＞0.05).The sputum smear/culture conversion rate (85.4％[41/48] vs 94.0％ [298/317],x2 =38.912,P＜0.01) and cavity closure rate (84.6％[22/26] vs 93.0％[198/213],x2 =20.709,P＜0.01) in patients with ATDILI were both significantly lower than those in patients without ATDILI.Conclusions The incidence of ATDILI is relatively high in hospitalized patients treated with first line anti-TB drugs.ATDILI has negative effects on treatment outcome of TB patient.Hepatitis B carrier with positive HBsAg and HBeAg,systemic lupus erythematosus,albumin ≤25 g/L and alcoholism may increase the risk of developing ATDILI.

Hematopoietic Stem Cell Transplantation ; Hepatocyte Growth Factor ; pharmacology ; Humans ; Immunologic Factors ; pharmacology ; Postoperative Period

Cysts ; congenital ; diagnosis ; surgery ; Female ; Humans ; Infant, Newborn ; Male ; Tongue Diseases ; congenital ; diagnosis ; surgery

Objective The controlled release BMP-2 and implantation into the acoustic bulla of the guineapig and the effects on the cochlea were observed.Methods The acellular cancellous bone was prepared,accompanied with BMP-2.The material accompanied with BMP-2 was implanted into one acoustic bulla of the animal,and the opposite side of the acoustic bulla was implanted with acellular cancellous bone without BMP-2.A total of 20 guinea-pigs were undergone this procedure.The ABR was tested on the animals before and after the operation immediately and 3 month after operation,respectively.3 month after operation,the animals were sacrificed.The osteogenesis induced by BMP-2,the acoustic bulla and the cochlea affected by BMP-2 were observed.The structures of hair cells were observed after being treated with silver nitrate.Results The animals recovered soon after surgery.The hearing thresholds of the animals reduced slightly after the operation,and recovered completely 3 month after.The bulla and the cochlea were normal in shape.The osteogenesis occurred in the pore of the acellular cancellous bone with BMP-2.No abnormal hyperplasia of bone in the hulla and the cochlea was found.The articulation between the stapes and oval window was not merged.The shape of the hair cells was normal and no obvious deletion of the hair cells was noted when compared with control group.Conclusion The controlled release BMP-2 could induce osteogenesis in the bulla of the animals.This material did not affect the shape of the bulla and the hearing thresholds.They did not induce any abnormal hyperplasia of bone in the bulla and might be used to reconstruct the affected ossicles.

Objective To study the clinicopathologic features and differential diagnosis of deep angiomyxoma(DAM). Methods Seven cases of DAM were collected from 2000 to 2008. All the patients were examined by microscopy and immunohistochemistry. Results 6 patients with DAM were females and 1 was male, with median age of 48.5 years. Median maximum dimension was 5.9cm, with invasive growth pattern. The tumor cells of DAM were infantile, spindle or stellate,diffuse and nodular arrangement. A distinctive histologic feature of DAM was its vascularity. Non-arborizing, thin-wall, ectastic capillaries or more commonly, small thick-wall vessels were dispersed throughout the tumor. Mast cells and extravasated red blood cells were frequently found in the stroma, immunohistochemical study showed that 7 cases were positive for vimentin, desmin, ER and PR, 5 for CD34 and SMA, and negative for S-100 and CK. Conclusion DAM is a rare soft tumor that occurs principally in the vulval and vagina region of woman. Misdiagnosis has happened frequently. Immunohistochemical staining are helpful to diagnosis for DAM, but no significance to distinguish it.

OBJECTIVETo compare clinical effects between percutaneous compressing plating (PCCP) and proximal femoral nail antirotation (PFNA) for the treatment of patients with intertrochanteric fracture with risk external wall.

METHODSFrom September 2007 to June 2010, 43 patients with intertrochanteric fracture with risk external wall were treated by PCCP or PFNA according to different kinds of internal fixations. There were 22 cases in PCCP, including 9 males and 13 females with an average age of 68.4 (ranged, 60 to 86) years old, and 13 cases with type A2.2 and 9 cases with type A2.3; while 21 cases in PFNA, including 7 males and 14 females with an average age of 67.7 (ranged, 57 to 93) years old, and 10 cases with type A2.2 and 11 cases with type A2.3. Blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up were observed and compared.

RESULTSAll patients were followed up for 12 to 22 (means 18.4) months, and all patients were obtained fracture healing, and recovered walking ability as before injury. There were no significant differences in blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up (P>0.05). One case occurred displacement on the top of greater trochanter, and 1 case injuried weakness of hip abduction. One case occurred screw breakage in PCCP, while 1 case occurred hip joint pain in PFNA.

CONCLUSIONBoth of PCCP and PFNA in treating patients with intertrochanteric fracture with risk external wall can receive good clinical effects, while the effects and therapy strategy for displacement of bone on the top of lateral wall should further study.

Aged ; Aged, 80 and over ; Bone Nails ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Intramedullary ; Fracture Healing ; Hip Fractures ; physiopathology ; surgery ; Humans ; Male ; Middle Aged

Objective To summarize the treatment results,operative complications and experiences of laparoscopic modified pull-through(Soave)precedure.Methods Twenty children with Hirschsprung disease(HD),16 males and 4 females,with age from 3.5 months to 4 years old,underwent laparoscopic modified pull-through(Soave)precedure under whole anesthesia and tracheal intubation,and the pathological colon was freed by ultrasonic surgical knife.Results All cases were operated on successfully.The average operating time was 132 min.The average resection colon was 35 cm and the average volume of bleeding was about 14 mL without blood transfusion.Two patients had postoperative enterocolitis;3 patients were no complications postoperation,such as constipation,soiling,intestinal obstruction,preianal intestine prolapse or cuff narrowing,and all patients had 1-2 bowel movements per day during a period of 6 months to 3 years follow-up.Conclusion Laparoscopic modified pull-through(Soave)precedure has smaller incision,less bleeding,quick recovery and less complications.

The fundus lesions appear in early pathological myopia and develops step by step,causing significant visual impairment.The occurrence of choroidal neovascularization is the main cause for the vision loss.This paper gives an introduction to the prevalence,damages,outcomes,affecting factors and treatment for pathologic myopia,and lays emphasis on the progress of medical treatment with anti-vascular endothelium growth factor.