To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Primary bronchial lung cancer, commonly known as lung cancer, is one of the malignant tumors with high morbidity and mortality in the world. In recent years, the incidence of lung cancer in women has increased, and most of them are lung adenocarcinoma. Because the early symptoms of lung cancer are occult, it is often detected when matastasis has already occurred. Endometrial and cervical metastasis is extremely rare for primary lung cancer. This article retrospectively analyzed the clinicopathological data of a patient with pulmonary microcapillary subtype adenocarcinoma with uterine and adnexal metastasis, and confirmed by morphology, immunohistochemistry and molecular detection, in order to provide references for clinical management of uterine and adnexal metastasis of lung adenocarcinoma.
.
Female ; Humans ; Adenocarcinoma of Lung/therapy* ; Lung Neoplasms/therapy* ; Uterine Neoplasms/therapy*

Objective: To predict the efficacy of endoscopic tissue adhesives in the treatment of gastric varices in patients with liver cirrhosis by Nomogram model. Methods: From August 2014 to September 2017, 158 patients with liver cirrhosis caused esophagogastric variceal bleeding and received endoscopic tissue adhesives treatment at Zhongshan Hospital, Fudan University were collected. All patients were followed for 12 months. The primary outcome was rebleeding. The factors of rebleeding after endoscopic treatment of esophagogastric varices were analyzed. Nomogram prognostic model was developed and compared with Child-Pugh grading, computed tomography angiography (CTA) and hepatic venous pressure gradient (HVPG) in prognostic accuracy in rebleeding after endoscopic treatment in liver cirrhosis caused esophagogastric varices. Univariate and multivaricate Cox regression analysis, Kaplan-Meier curve and log-rank test were performed for statistical analysis. Results: During the follow-up, rebleading occurred in 18 cases (11.4%), 37 cases (23.4%) and 49 cases (31.0%) at 2, 6, and 12 months after endoscopic treatment. The results of univariate Cox regression analysis showed the risk factors of rebleeding after endoscopic treatment of gastric varices included gender, alcoholic liver cirrhosis, diabetes mellitus, Child-Pugh grade (Grade A vs. B or C), extraluminal vessels on CTA (presence vs. absence) HVPG (<16 mmHg vs. ≥16 mmHg, 1 mmHg = 0.133 kPa), extensive portal embolism, esophageal varices, type 2 gastric varices, injection points of tissue adhesive (≤3 points vs. > 3 points), injection volume of tissue adhesive (≤ 3 mL vs. > 3 mL) (hazard ratio (HR)=0.575, 2.018, 1.562, 3.433, 2.945, 1.859, 2.743, 0.324, 1.840, 1.477, and 1.716; 95% confidence interval (CI) 0.305 to 1.084, 0.902 to 4.514, 1.753 to 6.724, 1.663 to 5.217, 1.012 to 3.415, 0.852 to 8.830, 0.079 to 1.335, 1.012 to 3.317, 0.839 to 2.602, and 0.935 to 3.152; all P<0.2). The results of multivariate Cox regression analysis indicated that Child-Pugh grade, extraluminal vessels by CTA, and HVPG (HR = 2.095, 95% CI 1.099 to 3.995, P = 0.025) were all independent risk factors of rebleeding after endoscopic treatment of gastric varices (HR=2.665, 2.886, and 2.095; 95% CI 1.339 to 5.300, 1.580 to 5.271, and 1.099 to 3.995; all P<0.05). Kaplan-Meier curves showed that Child-Pugh grade (Grade A vs. B or C), extraluminal vessels on CTA (presence or absent) and HVPG (<16 mmHg vs. ≥16 mmHg) could effectively predict cumulative non-rebleeding rate in one year after endoscopic treatment of gastric varices, and the differences were statistically significant (all P<0.05). Receiver operataring characteristic curve analysis demonstrated that the predictive value of the model combined with Child-Pugh grade, extraluminal vessels on CTA and HVPG was higher than that of Child-Pugh grade and HVPG (AUC=0.746, 0.673 and 0.585; 95% CI 0.662 to 0.829, 0.583 to 0.762, and 0.486 to 0.683; P<0.01, P=0.001 and P=0.089, respectively). Patients were divided into low, medium, and high-risk groups according to the 25th and 75th percentiles of the Nomogram score. The results showed that Nomogram model could effectively distinguish high-risk groups of rebleeding after endoscopic treatment of gastric varices, and the difference was statistically significant (P <0.01). Conclusions Extraluminal vessels on CTA, HVPG and Child-Pugh grade are independent prognostic evaluation indexes of rebleeding after endoscopic treatment of gastric varices. The predictive accuracy of Nomogram model based on these three prognostic factors may be better than Child-Pugh grade and HVPG.

Objective To investigate the natural infection of Theiler's murine encephalomyelitis virus (TMEV) in mice,and to survey the distribution of virus in tissues and the changes of serum antibody in the experimentally TMEV-infected mice.Methods Enzyme linked immunosorbent assay (ELISA) and fluorescence quantitative RT-PCR (qRT-PCR) assay were used to detect the antibody and nucleic acid of TMEV in clinical samples.These samples included SPF mice collected from Guangdong area in 2010-2015,mice obtained from a non-barrier laboratory rodent colony,and wild Rattus norvegicus live-trapped around the non-barrier laboratory rodent colony.36 ICR mice were intracerebrally inoculated with TMEV BeAn strain.The clinical signs of the animals were observed daily post-inoculation.Three mice were euthanatized at day 0,3,7,10,17,21,31,39 and 46 post-inoculation (dpi),respectively.Tissue and serum samples were collected for TMEV detection.Results The TMEV antibody and nucleic acid positive rates of SPF mice collected from Guangdong area in 2010-2015 were 5.29％ (n=2834) and 27.27％ (n=457),respectively.The TMEV antibody and nucleic acid positive rates of the mice obtained from a non-barrier laboratory rodent colony were 71.95％ (n=82) and 53.66％ (n=82),respectively.The TMEV nucleic acid positive rate of wild Rattus norvegicus was 25.93％ (n=27).In the TMEV positive mice,only two mice showed obvious clinical symptoms.The cecal contents,feces and brain samples were the best candidates for qRT-PCR assay.The viral nucleic acid could be detected in the brain,heart,liver,lung and stomach of ICR mice at 3 dpi,but no viral nucleic acid was detected in the spleen,kidney,and cecum.The viruses in liver,heart,lungs and stomach were completely cleared at 10 dpi,and the viruses persisted in the brain throughout the experiment.The TMEV antibody could be detected at 7 dpi,and then the antibody positive rate reached 100％ at 17 dpi.The antibody level increased gradually and maintained up to 46 days.ICR mice showed latent infection after TMEV inoculation,with no obvious symptoms and eye pathological changes.Conclusions The experimental mice and wild Rattus norvegicus in Guangdong area are both infected with TMEV,and the infection rate is high.The mice inoculated with TMEV BeAn strain show latent infection.The TMEV antibody produced in mice can be detected at 7 dpi and persisted until the end of the experiment.The viruses are found in the liver,heart,lung and stomach for a short time,but are persisted in the brain for a long time.There is a good consistency of TMEV detection between qRT-PCR and ELISA.The qRT-PCR assay can be used as a powerful complement method for the national standard of laboratory animals.

BACKGROUND:Rena gel and expansive sponge are two kinds of nasal packing materials, but there is stil a lack of comprehensive analysis on their filing effects.
OBJECTIVE:To compare the therapeutic efficacy of Rena gel and expansive sponge on nasal hemorrhage and postoperative nasal packing as wel as adverse reactions.
METHODS: A computer-based search of CBM, PubMed, EMBASE, Cochrane Library was performed for articles addressing randomized controled trials of Rena gel and expansive sponge as filing materials. The keywords were “Rena gel, randomized controled, expansive sponge” in Chinese and English, respectively. Then, aching feeling during filing and removal, sweling pain, bleeding, and bleeding control were compared and analyzed through a Meta-analysis.
RESULTS AND CONCLUSION:There were four randomized controled trials, involving 115 patients. The severity of pain was higher in the expansive sponge group than the Rena gel group when the filing materials were placed or removed (P < 0.05). However, there was no difference in the severity of pain between the two groups at 6 hours of filing (P > 0.05). The severity of sweling pain was higher in the expansive sponge group than the Rena gel group at 1 and 6 hours after filing (P < 0.05). When the filing materials were removed, the expansive group showed more severe bleeding than the Rena gel group (P < 0.05). No differences in the bleeding when filing and bleeding control were found between the two groups (P> 0.05). In addition, it was more difficult to fil or remove the expansive sponge from the nasal cavity (P < 0.05). These findings indicate that the Rena gel is superior to the expansive sponge in terms of pain, sweling pain, and bleeding when filing or removing the materials. But there is no difference in bleeding control between the two kinds of filing materials.

OBJECTIVE: To investigate the leukotriene D4 synthase gene A (LTD4S A)-444 C polymorphism in persistent allergic rhinitis (AR) of Chinese Han nationality and to evaluate its relevance to clinical responsiveness of leukotriene receptor antagonist. METHOD: There were 150 patients [87 males, 63 females, average age (38 +/- 14)] diagnosed with persistent AR in Allergy clinic in our hospital from March 2010 to March 2012; 146 healthy controls (78 males, 68 females, mean age (39 +/- 12)). We detected LT D4SA-444C polymorphism and allele frequencies with Polymerase Chain Reaction (PCR) and-Restriction Fragment Length polymorphism (RELP). The treatment group received monotherapy leukotriene receptor antagonist (montelukast) for 4 weeks. Urinary leukotriene D4 (LTD4) levels were detected by enzyme-linked immunosorbent assay (ELISA) before and after treatment, respectively. We evaluated anti-leukotriene treatment response according to the changement of symptoms, signs PTS and urinary LTD4. We tested correlation between LT D4S gene-444C allele frequency and the treatment response by multivariate analysis of variance. RESULT: (1) LTD4S gene-444 genotype AA/CC, AC/CC frequency is 70.7% (106/150) and 29.3% (44/150), allele A, C frequencies is 67.3% (101/150) and 32.7% (49/150) in AR group, and LTD4S gene-444 genotype AA/CC, AC/CC frequency is 76.7% (112/146) and 23.3% (34/ 146), allele A, C frequencies is 74.0% (108/146) and 26.0% (38/146) in healthy control group, there is not statistically significant difference between two groups. (2) Among 150 AR patients, compared to patients with AA/CC genotype, the genotype AC/CC patients are younger [average age (35 +/- 9), and (50 +/- 18) respectively, F = 5.891, P < 0.05], with earlier age of onset [(31 +/- 4), and (46 +/- 6) respectively, F = 6.985, P < 0.05], longer course of disease [(8.7 +/- 2.1), and (3.1 +/- 2.0) respectively, F = 11.43, P < 0.05], higher symptom scores (8.2 +/- 0.2; 4.8 +/- 0.3), higher signs score (7.3 +/- 3.3; 3.4 +/- 5.1), and the difference was statistically significant. (3) After 4 weeks of montelukast treatment in AR patients, treatment response of anti-leukotriene in genotype AC/ CC patients is better than those in AA/CC genotype patients (F = 11.01, P < 0.05), the differences of treatment response between two groups were correlated with LTD4 levels in vivo, clinical symptoms and signs of patients. CONCLUSION In a Chinese Han population the LTD4SA-444B polymorphism might be one of the factors in the clinical response to leukotriene receptor antagonists in persistent AR patients.
Adult ; Arachidonate 5-Lipoxygenase ; genetics ; Case-Control Studies ; Female ; Gene Frequency ; Humans ; Leukotriene Antagonists ; therapeutic use ; Male ; Middle Aged ; Polymorphism, Genetic ; Rhinitis, Allergic ; drug therapy ; genetics ; Young Adult

OBJECTIVE: To evaluate the treatment responses of persistent allergic rhinitis with and without eosinophils (EOS) in nasal discharge to inhaled glucocorticosteroid (CS), and therefore to verify whether low eosinophil level in nasal discharge can predict poor response to treatment with CS. METHOD: Forty-two symptomatic allergic rhinitis patients, who had not received CS therapy in three months preceding the study, were examined before and 2 month, 4 months and 6 months after treatment with CS. At each visit, all patients underwent symptom scoring and physical sign scoring. The level of eosinophil cationic protein (ECP) in the nasal discharge supernatants was measured by radioimmunoassay. The patients were divided into 2 groups according to nasal discharge EOS percentages, an EOS group (EOS > or = 3%) and a non-EOS group (EOS < 3%). The response to CS therapy (as measured by symptom and physical sign scores) and the changes of nasal discharge measurements were compared between the 2 groups. RESULT: In the EOS group, the baseline EOS [0.086 (0.065; 0.176)] and ECP level [(326 +/- 145) microg/L] were significantly higher than EOS [0.016 (0.005; 0.022)] and ECP level [(154 +/- 58) microg/L] of the non-EOS group, t = 4.40, 3.32, respectively, all P < 0.01. After 2 months and 6 months of CS therapy, the nasal discharge EOS, ECP level were 0.038 (0.006; 0.070), 0.019 (0.010; 0.060), (175 +/- 122) microg/L, (175 +/- 153) microg/L, respectively in the EOS group,which were significantly different as compared to baseline values (F = 6.73, 7.38, respectively all P < 0.05). But in the non-EOS group, the nasal discharge EOS and ECP level were 0.014 (0.004; 0.032), 0.015 (0.010; 0.026), (118 +/- 60) microg/L, (112 +/- 60) microg/L, respectively at 2 and 6 months, which showed that the nasal discharge EOS level and the symptom and physical sign scores did not improve significantly (F = 0.82, P > 0.05), but the ECP level did improve (F = 3.78, P < 0.05). The average daily dose of CS was not different between the two groups at any visits. CONCLUSION In persistent allergic rhinitis with low EOS in nasal discharge, CS therapy for 6 months failed to improve symptoms and physical signs.
Administration, Inhalation ; Adult ; Eosinophil Cationic Protein ; Eosinophils ; pathology ; Female ; Glucocorticoids ; administration & dosage ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Rhinitis, Allergic ; drug therapy ; metabolism ; pathology ; Treatment Outcome

OBJECTIVE: Investigate the effect of three-grade preventive health education and lifestyle intervention in the treatment of allergic rhinitis (AR). METHOD: Two hundred and ten selected cases needed for triple prevention were randomly divided into three groups, each group included 70 cases were undertaken for a three-year randomized controlled study. Group A, treated with Budesonide nasal spray. Group B, combined Budesonide nasal spray with Hydrochloric acid left Kabbah Sting nasal spray. Group C, taking health education management and lifestyle intervention on the basis of group B's therapy. A health lecture or health problems counseling and the dissemination of health education information were undertaken, quarterly. It was mainly for health knowledge awareness, and healthy behaviors formation rate guidance. Lifestyle intervention included a balanced diet, avoiding the allergens of living environment and aerobic exercise (daily 0.5-1.0 h). The score of the signs and symptoms in each group were obtained respectively at the beginning of study, 1 year after intervention and 3 years after intervention, as well as the comparison of patient compliance of follow-up. RESULT: The improved score of the signs and symptoms, endoscopy and radiological results were used to evaluate the treatment effect. There was no significant difference among the score of signs and symptoms in three groups. Comparing in group, before intervention,1 year after intervention and 3 years after intervention, the signs and symptoms of patients in three groups had improvement at different degree. The score of four symptoms (rhinobyon, rhinorrhoea, rhinocnesmus, sneezing) and signs were significant lower than before the intervention, there were a significant difference (P < 0.05). There were 8 patients in group A (11.43%), 6 patients in group 13 (8.57%) and 1 patient in group C (1.43%) lost to follow-up at 3 years after the intervention. The patient compliance of group C was significantly higher than groups A and B. CONCLUSION Triple prevention health education for AR can significantly improve the treatment compliance of AR patients for treatment, while ensuring clinical efficacy.
Adult ; Budesonide ; therapeutic use ; Health Education ; Humans ; Life Style ; Middle Aged ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; prevention & control ; therapy

OBJECTIVE: To investigate the changes of leukotriene D4 (LTD4) in nasal discharge and plasma of patients with persistent allergic rhinitis (AR) and the effects of antihistamine. METHOD: The investigation was a prospective, randomized controlled trial. Forty AR patients (group C) were divided randomly into two subgroup. One group received oral antihistamine 10 mg everyday for one week (group CA) and another group received no loratadine tablets 10 mg everyday for one week (group CB). Fifteen age matched healthy (group D) people were enrolled as control. The level of LTD4 and interleukin-5 (IL-5) in both nasal discharge and plasma by using enzyme linked immunosorbent assay (ELISA) and enzyme immunoassay (EIA), cell counts and cell differentials in nasal discharge, were measured before and after three month. The clinical symptom and life quality scores of group C were also investigated. RESULT: The concentrations of LTD4 in nasal discharge [(794 +/- 305) pg] and plasma [(5219 +/- those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P 1185) ng/L] in group C were significantly higher than those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P < 0.05]. The level of LTD4 in nasal discharge was positively correlated with the percentage of neutrophil (r = 0.453, P < 0.05) and IL-5 (r = 0.364, P < 0.05). The pre- and post-therapy concentrations of nasal discharge and plasma in group CA were (812 +/- 1592) pg, (657 +/- 495) pg and (5422 +/- 935) ng/L, (4589 +/- 1057) ng/L respectively; While in group CB the concentrations were (776 +/- 227) pg, (860 +/- 194) pg and (5074 +/- 1850) ng/L, (6063 +/- 450) ng/L, respectively. There were no significant difference either in the level of LTD4 in nasal discharge or in plasma in both groups (all P > 0.05). CONCLUSION The results suggested that LTD4 was involved in airway inflammation in AR. Antihistamine was not effective enough in decreasing the levels of LTD4 in both nasal discharge and plasma of AR patients.
Adult ; Anti-Allergic Agents ; pharmacology ; Bodily Secretions ; chemistry ; Female ; Histamine H1 Antagonists ; pharmacology ; Humans ; Leukotriene Antagonists ; therapeutic use ; Leukotriene D4 ; analysis ; blood ; metabolism ; Male ; Middle Aged ; Plasma ; chemistry ; Prospective Studies ; Rhinitis, Allergic, Perennial ; blood ; drug therapy ; metabolism