Objective To investigate the changes of adhesion molecules and their effects on skeletal muscle ischemia/reperfusion injury. Methods 42 Wistar rats were divided into 3 groups: normal control group (Group Ⅰ, n=6), ischemia group (Group Ⅱ, n=6),ischemia/reperfusion injury group (Group Ⅲ, n=30). The level of malondialdehyde (MDA) in the plasma, myeloperoxidase (MPO) in the skeletal muscle, CD11b/CD18 on the leukocytes, intercelluar adhesion molecule-1 (ICAM-1) in the skeletal muscle and the histological changes were studied 1 h, 2 h, 4 h, 8 h, 12 h reperfusion after ischemia for 4 h. Results In group Ⅲ, the expression of CD11b/CD18, ICAM-1 and the injury of skeletal muscle increased with the lapse of reperfusion time. They reached the peak at 8～12 hours' reperfusion. The injury of skeletal muscle developed with the expression of adhesion molecules. Conclusion The expression of CD11b/CD18 and ICAM-1 are significantly associated with the skeletal muscle ischemia-reperfusion injury.

Objective To discuss the reasons of false judgments of localization of the rupture aneurysms and find the way to fix this problem in patients with multiple intracranial aneurysms. Methods The clinical data of 25 consecutive patients, who presented with their first spontaneous subarachnoid hemorrhage and had multiple intracranial aneurysms from 2003 to 2009 in our hospital, were analyzed retrospectively. The rupture aneurysms were determined according to Nehls' method that reported before, and the supposed responsible rupture aneurysms w0ere clipped within 48 hours after hemorrhage in all patients. More aneurysms that could not be accessed in the same surgical session were surgically terated later. Results The location of the rupture aneurysm was verified at the time of surgery in all 25 patients. The concordance rate of the prediction and the reality of the rupture aneurysm was 80% (20/25). Four patients ( 16% ) ,in whom the ruptured aneurysm was not correctly identified,rebled after surgery,and 2 patients died as a result of the rebleeding One patients had no clear diagnosis at the end. Conclusion In the reported cases, about 80% rupture aneurysms could be correctly diagnosed before treatment according to the CT and DSA examinations. If clear diagnosis couldn't be made,additional examinations should be considered, such as CTA or MRI. Rupture aneurysms must be confirmed during the operation and the other aneurysms should be checked to exclude additional responsible aneurysms in all cases.

Objective To evaluate the effect of computer-aided design of composite materials with epoxide acrylate maleic (E) and hydroxyapatite (H) in cranioplasty. Methods A total of 45 patients with cranium defects were treated with cranioplasty by using skull bone flaps made of composite materials including epoxide acrylate maleic (E) and hydroxyapatite (H) ,which was designed with computer aid according to individual requirements. The patients were followed up for 6-36 months. Results After cranioplasty with composite EH, there occurred subcutaneous fluid in one patient and mild bone collapse in one. The composite EH showed good histocompatibility, with no infection or rejection. Conclusion During cranioplasty, use of computer-aided design of composite EH takes advantages of good accuracy, short operation time, good biocompatibility and good clinical efficiency.

Objective:To analyze clinical characteristics of cosmetics-related adverse reactions and main allergenic components of cosmetics, to provide guidance for cosmetics-related adverse reaction monitoring, and to provide an objective basis for risk assessment.Methods:A total of 512 patients with suspected cosmetic adverse reactions were collected from the outpatient clinic of Chongqing Traditional Chinese Medicine Hospital from March 2018 to October 2019, including 14 males and 498 females. A uniform cosmetic adverse reaction report card was filled in, and medical history of patients and related information about the used cosmetics were recorded; 103 patients (3 males and 100 females) were subjected to patch test with their own cosmetics or cosmetic ingredients, and 48- and 72-hour patch test results were combined for comprehensive determination and analysis.Results:Among the 512 cases of suspected cosmetic adverse reactions, contact dermatitis (495 cases, 96.7%) was the most common manifestation. Cosmetic adverse reactions mainly manifested as erythema (501 cases, 97.9%), papules (313, 61.1%), edema (249, 48.6%), and scaling (166, 32.4%) ; main symptoms included itching (480, 93.8%), burning sensation (359, 70.1%), and tense sensation (297, 58.0%). Patch test with cosmetic ingredients showed positive reactions in 71 of 103 cases, and thimerosal was the allergen mostly liable to cause adverse reactions (31 cases, 30.1%), followed by sodium dodecyl sulfate (29 cases, 28.2%), Peru balsam (17 cases, 16.5%), bronopol (12 cases, 11.7%) and triethanoamine (10 cases, 9.7%). The cosmetic allergens were divided into 14 categories, and the top 4 categories with high positive patch test rates were emulsifiers (54 cases, 45.8%), preservatives (47 cases, 39.8%), fragrances (17 cases, 14.4%) and surfactants (10 cases, 8.5%). Positive patch test reactions were observed in 2 males and 69 females, and there was no significant difference in the positive rate between males and females (2/3 vs. 69/100, χ2 = 0.01, P > 0.05) ; there was also no significant difference in the positive rate among the groups aged 18 - 29 years (34%), 30 - 49 years (34%) and 50 - 70 years (32.4%; χ2 = 0.693, P > 0.05) . Conclusions:Contact dermatitis is the most common adverse reaction to cosmetics. Among the diverse allergenic components of cosmetics, thimerosal is the allergen that is mostly liable to cause adverse reactions, followed by sodium dodecyl sulfate, Peru balsam, bronopol and triethanoamine.

Objective:To compare the detection performance of serum free light chain (sFLC) in two platforms and evaluate the comparability of serum free light chain results in patients with multiple myeloma (MM).Methods:To evaluate the detection performance (repeatability, accuracy, linear range, reference range, interfering substances, etc.) of sFLC kit based on polyclonal antibodies. Spearman correlation analysis and Bland-Altman were used to analyze 214 sFLC results obtained on two detection platforms at the same time to evaluate the correlation between the results of the two methods and analyze the causes of methodological bias. 119 cases with aMM and 23 cases of disease control group (AL, WM, POEMS syndrome, MGUS, diffuse large B-cell lymphoma) initially diagnosed in the hematology department of Zhongshan Hospital of Fudan University from March 2020 to March 2021 were all included. A retrospective analysis was conducted to calculate the area under the curve of receiver operating characteristic (AUC-ROC) and obtain the optimal sensitivity and specificity cut-off points for the diagnosis of MM patients on monoclonal antibody platform.Results:Repeatability, accuracy, linear range, reference interval and anti-interfering capacity of the detection platform based on polyclonal antibodies were verified to meet clinical needs. The overall consistency of FLC/κ, FLC/λ and κ/λ ratios in two methods was 89.3%, 84.1% and 77.1% respectively; but the correlation results were highly heterogeneous. The correlation coefficient of FLC/κ R 2 was 0.922( P<0.001), while the correlation coefficients R 2of the FLC/λ and κ/λ ratios were only 0.349 and 0.441( P<0.001). After segment analysis, it was found that the correlation of FLC/λ was improved within the linear range and R 2 could rise to 0.78( P<0.001). Compared with monoclonal antibody platform, the vast majority points of FLC/κ fell within the 95% limit by Bland Altman analysis. While the results of FLC/λ on polyclonal antibody platform showed significant positive bias. The AUC of MM diagnosis on monoclonal antibody platform was 0.751 ( P=0.001), and the optimal cutoff value was 24.67. Conclusion:The overall consistency between the two platforms was good, but there were significant differences between the results, so they were not comparable and could not be interchanged. For monitoring the prognosis of patients with multiple myeloma, the same platform should be selected for testing.

Objective:To summarize the prognosis of medullary thyroid carcinoma (MTC) patients with biochemical recurrence (the increase of postoperative calcitonin and no abnormal imaging) and to investigate the optimal cut-off value of calcitonin for postoperative structural recurrence (with imaging abnormality).Methods:Literature retrieval was conducted for PubMed, CNKI, EMbase, Web of Science, Cochrane and other databases, and literatures related to the increase of calcitonin after MTC surgery were included. Review Manager 5.4 software was used for Meta-analysis of the recurrence and death. SPSS 23.0 software was used and receiving operating characteristic (ROC) curve was used to analyze the rising folds of postoperative calcitonin level in comparison with the maximum value of experiment detection, and to predict the outcome of biochemical recurrence transforming to structural recurrence, and then the optimal cut-off value could be worked out.Results:A total of 7 studies including 1 005 MTC patients (276 cases of biochemical recurrence and 542 cases of biochemical cure). Meta-analysis showed that structural recurrence rate in postoperative biochemical recurrence group [40.6% (112/276) vs. 2.2% (12/542); OR = 27.99, 95% CI 14.57-53.78, P < 0.001] and mortality [10.0% (19/190) vs. 0.96% (3/312); OR = 7.26, 95% CI 2.42-21.84, P < 0.001] were higher than those in the biochemical cure group (normal postoperative calcitonin level and no disease state). The data of 89 MTC patients with biochemical recurrence were collected in another 4 studies. ROC curve analysis showed that area under the curve of the rising folds of postoperative calcitonin level in predicting structural recurrence was 0.825; according to the cut-off value at all sections, the optimal cut-off value of the increased postoperative calcitonin was 50 times, the sensitivity was 66. 7%, the specificity was 88.6%. Conclusions:MTC patients with postoperative biochemical recurrence have higher structural recurrence rate and mortality compared with patients with normal postoperative calcitonin. The postoperative elevation of calcitonin more than 50 times the maximum value of the laboratory detection can be taken as the critical diagnostic value, when more than 50 times is prone to structural recurrence.

Female ; Humans ; Breast Neoplasms ; Testosterone ; Prolactin ; Estradiol ; Testosterone Congeners ; China

Objective To analyze the clinical features of patients with coronavirus disease 2019 (COVID-19) in Shanghai and to investigate the risk factors for disease progression to severe cases. Methods The clinical data of 292 adult patients with COVID-19 hospitalized in Shanghai Public Health Clinical Center from January 20, 2020 to February 10, 2020 were retrospectively analyzed, including 21 severe patients and 271 mild patients. The demographic characteristics, epidemiological history, history of underlying diseases and laboratory examinations were compared between the two groups. Measurement data were compared using t test or Mann-Whitney U test. The count data were compared using hi-square test. The binary logistic regression equation was used to analyze the risk factors for the progression of patients to severe cases. Results Among the 292 patients, 21 were severe cases with the rate of 7.2% (21/292). One patient died, and the mortality rate was 4.8% in severe patients. The severe patients aged (65.0±15.7) years old, 19 (90.5%) were male, 11 (52.4%) had underlying diseases, 7 (33.3%) had close relatives diagnosed with COVID-19. The mild patients aged (48.7±15.7) years old, 135 (49.8%) were male, 74 (27.3%) had underlying diseases, 36 (13.3%) had close relatives diagnosed with COVID-19. The differences between two groups were all significant statistically ( t =-4.730, χ 2 =12.930, 5.938 and 4.744, respectively, all P <0.05). Compared with the mild patients, the levels of absolute numbers of neutrophils, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatinine, serum cystatin C, C reactive protein (CRP), procalcitonin , D -dimer, pro-B-type natriuretic peptide (proBNP), serum myoglobin, creatine kinase (CK), creatine kinase isoenzyme (CK-MB), serum troponin I (cTnI) in severe patients were all significantly higher ( U =2 091.5, 1 928.0, 1 215.5, 729.0, 1 580.5, 1 375.5, 917.5, 789.5, 1 209.0, 1 434.0, 638.0, 964.5, 1 258.0 and 1 747.5, respectively, all P <0.05), while the levels of lymphocyte count, albumin, transferrin, CD3 + T lymphocyte count, CD8 + T lymphocyte count and CD4 + T lymphocyte count in severe patients were all significantly lower ( U =1 263.5, t =4.716, U =1 214.0, 962.0, 1 167.5 and 988.0, respectively, all P <0.05). Further logistic regression analysis showed that the albumin (odds ratio ( OR )=0.806, 95% CI 0.675-0.961), CRP ( OR =1.016, 95% CI 1.000-1.032), serum myoglobin ( OR =1.010, 95% CI 1.004-1.016), CD3 + T lymphocyte count ( OR =0.996, 95% CI 0.991-1.000) and CD8 + T lymphocyte count ( OR =1.006, 95% CI 1.001-1.010) at admission were independent risk factors for the progression of COVID-19 patients to severe illness (all P <0.05). Conclusions Severe cases of patients with COVID-19 in Shanghai are predominantly elderly men with underlying diseases. Albumin, CRP, serum myoglobin, CD3 + T lymphocyte count and CD8 + T lymphocyte count could be used as early warning indicators for severe cases, which deserve more clinical attention.