Objective:To investigate the clinical features of chronic spontaneous urticaria (CSU) patients with angioedema (AE) .Methods:Clinical data were collected from adult outpatients with active CSU diagnosed and treated at the First Hospital of China Medical University from January 2019 to December 2021, and analyzed retrospectively. The data included gender, age, disease duration, the presence or absence of angioedema, urticaria activity score for one day, prior treatments, previous history, family history, laboratory test results, therapeutic effect, and adverse reactions. Their treatment regimens were based on the Chinese guidelines for the diagnosis and treatment of urticaria (2018) and the American guidelines for the diagnosis and management of urticaria (2014). Statistical analysis was carried out by using Mann-Whitney U test, two-independent-sample t test, Chi-square test, corrected Chi-square test, and Fisher's exact test. Results:A total of 131 CSU patients were collected, including 78 females and 53 males. Their age at the first visit was 44.6 ± 13.3 years, and the disease duration ( M[ Q1, Q3]) was 4.0 (2.0, 10.0) months. Among these CSU patients, there were 58 with AE and 73 without AE. The disease duration was significantly longer in the CSU patients with AE (6.0 [3.0, 24.0] months) than in those without AE (3.5 [2.0, 6.0] months; Z = -2.78, P = 0.005). The urticaria activity score for one day was also significantly higher in the CSU patients with AE (5.0 [3.0, 5.3] points) than in those without AE (4.0 [3.0, 5.0] points; Z = -2.63, P = 0.008). The CSU patients with AE showed a decreased proportion of patients completely controlled by licensed-dose second-generation H1-antihistamines (sgAHs) (8.6%, 5/58) compared with those without AE (24.7%, 18/73), but an increased proportion of patients uncontrolled by licensed-dose sgAHs (91.4%, 53/58) compared with those without AE (74.0%, 54/73; Z = -2.53, P = 0.011) ; there were no significant differences in the proportions of patients completely controlled or uncontrolled by updosed sgAHs alone or combinations of 2- to 4-fold equivalent-dose sgAHs, or in the proportions of patients completely controlled or uncontrolled by combination therapy with 4-fold equivalent-dose sgAHs and non-H1-antihistamines between the CSU patients with AE and those without AE ( P > 0.05) . Conclusion:Compared with the CSU patients without AE, the CSU patients with AE had a longer disease duration, higher disease activity, a lower proportion of patients completely controlled by licensed-dose sgAHs, and a higher proportion of patients uncontrolled by licensed-dose sgAHs.

OBJECTIVE: To investigate the short-term effectiveness of transverse antecubital incision in the treatment of failed closed reduction of Gartland type Ⅲ supracondylar humeral fractures (SHFs) in children. METHODS: Between July 2020 and April 2022, 20 children with Gartland type Ⅲ SHFs who failed in closed reduction were treated with internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision. There were 9 boys and 11 girls with an average age of 3.1 years (range, 1.1-6.0 years). The causes of injuries were fall in 12 cases and fall from height in 8 cases. The time from admission to operation ranged from 7 to 18 hours, with an average of 12.4 hours. The healing of the incision and the occurrence of complications such as nerve injury and cubitus varus were observed after operation; the elbow flexion and extension range of motion after removing the gypsum, after removing the Kirschner wire, and at last follow-up were recorded and compared, as well as the elbow flexion and extension and forearm rotation range of motion at last follow-up between healthy and affected sides; the Baumann angle was measured on the X-ray film, and the fracture healing was observed. At last follow-up, the effectiveness was evaluated according to the Flynn elbow function evaluation criteria. RESULTS: All incisions healed by first intention, and there was no skin necrosis, scar contracture, ulnar nerve injury, and cubitus varus. Postoperative pain occurred in the radial-dorsal thumb in 2 cases. The gypsum was removed and elbow flexion and extension exercises were started at 2-4 weeks (mean, 2.7 weeks) after operation, and the Kirschner wire was removed at 4-5 weeks (mean, 4.3 weeks). All the 20 patients were followed up 6-16 months, with an average of 12.4 months. The fracture healing time was 4-5 weeks, with an average of 4.5 weeks, and there was no complication such as delayed healing and myositis ossificans. The flexion and extension range of motion of the elbow joint gradually improved after operation, and there were significant differences between the time after removing the gypsum, after removing the Kirschner wire, and at last follow-up ( P<0.017). There was no significant difference in the flexion and extension of the elbow joint and the forearm rotation range of motion between the healthy and affected sides at last follow-up ( P>0.05). There was no significant difference in Baumann angle between the time of immediate after operation, after removing the Kirschner wire, and at last follow-up ( P>0.05). According to Flynn elbow function evaluation standard, 16 cases were excellent and 4 cases were good, the excellent and good rate was 100%. CONCLUSION The treatment of Gartland type Ⅲ SHFs in children with failed closed reduction by internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision has the advantages of complete soft tissue hinge behind the fracture for easy reduction and wire fixation, small incision, less complications, fast fracture healing, early functional recovery, reliable reduction and fixation, and can obtain satisfactory results.
Male ; Female ; Humans ; Child ; Child, Preschool ; Calcium Sulfate ; Humerus ; Humeral Fractures/surgery* ; Plastic Surgery Procedures ; Fracture Fixation, Internal/methods* ; Bone Wires ; Fracture Healing ; Treatment Outcome ; Range of Motion, Articular

Objective:To explore the effect of family empowerment model based on cloud follow-up in schizophrenia patients and their main caregivers.Methods:From January 2020 to June 2021, 160 schizophrenics and their 160 main caregivers who were admitted to Shaoxing Seventh People's Hospital were selected as the study subject by convenience sampling. According to the method of random number table, the subjects were divided into control group and observation group, with 80 patients and 80 main caregivers in each group. The patients in the control group were given routine nursing, while the patients in the observation group received family empowerment nursing model based on cloud follow-up on the basis of the control group. Both groups of patients were intervened continuously for six months after enrollment. Morisky Medication Adherence Scale-8 (MMAS-8) , Personal and Social Performance Scale (PSP) , Family Environment Scale-Chinese Version (FES-CV) , Self-Perceived Burden Scale (SPBS) , Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to evaluate the drug compliance, personal social function, family function of the two groups of patients, disease burden and negative emotions of main caregivers.Results:After six months of intervention, the medication compliance of observation group was better than control group, the difference was statistically significant ( P<0.05) . The PSP score of patients in the observation group was higher than that of the control group, and the FEC-CV scores in all dimensions of the observation group were better than that of the control group, with statistically significant differences ( P<0.05) . After intervention, the disease burden, SAS and SDS scores of the main caregivers in the observation group were lower than those in the control group, with statistically significant differences ( P<0.05) . Conclusions:The family empowerment model based on cloud follow-up can improve the treatment compliance, personal social function and family environment of schizophrenics, and relieve the disease burden and negative emotions of the main caregivers, which is worthy of clinical practice.

A 3-year-old girl was hospitalized for cough and asthma for 2 days, and fever and anuria for 1 day in Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in January 2019.Retrospective analysis was used.She developed end-stage renal disease and received peritoneal dialysis 6 months ago.After admission, she was diagnosed as acute-on-chronic renal failure, respiratory failure, heart failure, severe influenza A (H1N1). The patient was rapidly recovered by the management of high-volume peritoneal dialysis, mechanical ventilation, and medications of Peramivir and Methylprednisolone.Through literature review, case report or cohort study about the treatment of acute kidney disease by high-volume peritoneal dialysis has not been previously reported.This case report suggested that high-volume peritoneal dialysis is able to effectively remove solutes and control volume without causing severe hypoproteinemia and hyperglycemia, which may become an effective renal replacement therapy for children with multi-organ dysfunction syndrome.

Objective:To investigate the status of anticipatory grief among primary caregivers of families with advanced Alzheimer′s disease (AD) and analyze the influencing factors.Methods:A total of 160 primary caregivers in the families of AD patients in the middle and late stage who were treated in Shaoxing Seventh People′s hospital from August 2018 to September 2019 were selected as research subjects to investigate caregivers′ gender, age, education level, relationship with patients, reasons for taking care of patients, and the patients′ time of illness, combined diseases, and self-care ability. Anticipatory Grief Scale was used to compare the anticipatory grief level (AGL) of caregivers with different characteristics, and Pearson correlation analysis was used to analyze the correlation between the anticipatory grief and burden of caregivers, with a further exploration of the factors affecting caregivers′ anticipatory grief.Results:The anticipatory grief score of primary caregivers of families with AD patients in the middle and late stage was (83.88±17.21). Single factor analysis showed the following facts: the AGL of female caregivers was higher than that of males ( t =12.337, P<0.05); the AGL of spouses was higher than that of children and other family members ( F=10.940); the AGL showed in caretaking based on willingness was lower than that based on responsibility and obligation, and the reason was because other people were available ( F=4.501); the AGL of caregivers of patients with 5-10 years of illness was higher than that of those with 2-4 years of illness ( F=6.014); the AGL of caregivers of patients with more than 3 kinds of other diseases was higher than that of those with less than 1 and 2 kinds of other diseases; the AGL of caregivers of patients with no self-care ability was higher than that of those of patients who lost partial or most self-care ability ( F=5.712). The burden score of primary caregivers of patients in the middle and late stages of AD was (50.19±12.61). Pearson correlation analysis indicated that the anticipatory grief of caregivers was positively correlated with their burden of care ( r=0.581, P<0.001), and multiple regression analysis showed that the caregivers′ gender and relationship with patients, patients′ time of illness, and capacity of self-care, and the caregivers′ burden are the main factors influencing the anticipatory grief of caregivers in families of patients in the middle and late stages of AD (all P<0.05). Conclusion:There exists serious anticipatory grief among primary caregivers in families of patients in the middle and late stages of AD. The main influencing factors include caregivers′ gender, burden of care, relationship with patients, patients′ time of illness, and self-care capacity. Health management should be enhanced to improve the quality of life of the primary caregivers of patients in the middle and late stages of AD.

Objective: To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Methods: Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate. Results: 32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34- ~ 21.15) mmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31- ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) mmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively. Conclusion The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.

Objective:To investigate the risk factors, severity of symptoms, acute exacerbations, and pulmonary function in women with chronic obstructive pulmonary disease (COPD).Methods:A total of 4 204 COPD patients, including 533 female COPD patients and 3 671 male COPD patients, were investigated from January 2017 to December 2019 in Second Xiangya Hospital of Central South University, Hunan Prevention and Treatment Institute for Occupational Disease, affiliated Hospital of Guilin Medical College and Guilin Second People's hospital. The risk factors, severity of symptoms, risk of acute exacerbation and clinical characteristics of pulmonary function in patients with COPD were comprehensively analyzed.Results:There was no statistical difference in age between male and female COPD patients ( P>0.05). There were statistically significant differences in smoking history, occupational exposure history and biofuel exposure history ( P<0.001), among which smoking history and occupational exposure history were significantly higher in males than in females ( P<0.001), and exposure history of biofuels was significantly higher in females than in males ( P<0.001). The COPD assessment test (CAT) score of male and female patients was statistically different ( P<0.05), and the mean CAT score of female patients was higher than that of male patients. The modified medical research council dyspnea scale (mMRC) grading results of male and female patients were statistically different ( P<0.05), and the mMRC grading of female patients was higher than that of male patients. There was no statistical difference in the risk of acute exacerbation between male and female patients ( P>0.05). There were statistically significant differences between male and female patients in first second exertional volume as a percentage of predicted value (FEV 1%) and forced expiratory volume in one second/forced vital capacity (FEV 1/FVC) mean value ( P<0.001), and FEV 1% predicted value and FEV 1/FVC of female patients were better than that of male patients. Conclusions:The risk factors, symptom severity and pulmonary function of female patients with COPD are different from those of male patients, providing reference for the individualized treatment of female patients with COPD.

To observe the effects of human umbilical cord mesenchymal stem cells (UC-MSCs) on the proliferation and apoptosis of human ovarian cancer cell SKOV3.
 Methods: Transwell co-culture was used to observe the targeted homing effect of UC-MSCs on ovarian cancer cells. MTT assay was used to detect the inhibitory effect of UC-MSCs conditioned medium on SKOV3 proliferation, and Annexin V-FITC/PI double staining was used to detect the apoptotic rate. Real-time PCR was used to detect the expression levels of Ki-67, Bcl-2 and Bax genes-relevant to proliferation and apoptosis of SKOV3 cells.
 Results: UC-MSCs targeted SKOV3 cells in vitro. MTT assay showed that UC-MSCs conditioned medium significantly inhibited the proliferation of SKOV3 cells (P<0.01). Annexin V-FITC/PI double staining showed that the apoptotic rate in the 75% conditioned medium group was significantly higher than that in the control group (P<0.05). Real-time PCR showed that the expression of proliferation-related gene Ki-67 decreased significantly (P<0.01). The apoptosis-related gene Bcl-2 expression was decreased dramatically (P<0.01), and Bax expression was increased significantly (P<0.01).
 Conclusion: UC-MSCs can target ovarian cancer cells in vitro, inhibit the proliferation of SKOV3 cells by regulating the expression of Ki-67, and promote the apoptosis of SKOV3 cells by regulating the expression of Bcl-2 and Bax.
Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Female ; Humans ; Mesenchymal Stem Cells ; Ovarian Neoplasms ; Umbilical Cord

Objective To compare the production of farnesol between Candida albicans (C.albicans) biofilms formed by resistant and standard strains in different media,and to investigate the changing trend of farnesol production in different phases of biofilm formation and the features of farnesol production by resistant C.albicans.Methods Fluconazole-resistant C.albicans strains were induced in vitro.Standard strains and fluconazole-resistant strains of C.albicans were separately inoculated onto different media,including RPMI 1640 medium,yeast extract peptone dextrose (YPD) medium,yeast nitrogen base (YNB) + 0.5％ glucose medium,RPMI 1640 + 10％ fetal calf serum (FCS),so as to form C.albicans biofilms.Morphological changes of C.albicans biofilms at 24 hours were observed under an inverted microscope,and gas chromatography-mass spectrometry (GC/MS)was performed to detect the level of farnesol at 1.5,3,6,12,24,36 and 48 hours.Results There were no obvious differences in the morphology of C.albicans biofilms between the resistant and standard strains when they were cultured in the same medium,while the morphology of C.albicans biofilms markedly differed between the 2 kinds of strains in the different media.Three-factor analysis of variance showed that the production of farnesol in the C.albicans biofilms changed over time (F =70.628,P ＜ 0.001).Concretely speaking,during the formation of resistant and standard C.albicans biofilms,the production of farnesol gradually increased in the RPMI 1640,YPD and YNB + 0.5％ glucose media until the biofilms matured,then showed a decreasing trend.However,the time to peak levels of farnesol was different between the 2 kinds of strains in these media.Moreover,the levels of farnesol in the 2 kinds of strains both slowly increased in the RPMI 1640 + 10％ FCS medium within 12-48 hours.Culture media also significantly affected the production of farnesol (F =176.665,P ＜ 0.001),and the levels of farnesol in the resistant and standard C.albicans biofilms were both higher in the YNB + 0.5％ glucose medium.When resistant and standard strains were separately cultured in the RPMI 1640 media and the YPD media,the level of farnesol was significantly higher in the resistant strains than in the standard stains (RPMI 1640 media at 36 hours:1.157 ± 0.064 vs.0.250 ± 0.075,P ＜ 0.05;YPD media at 6 hours:0.262 ± 0.036 vs.0.055 ± 0.062,P ＜ 0.05;YPD media at 12 hours:0.730 ± 0.030 vs.0.482 ± 0.024,P ＜ 0.05).However,when they were separately cultured in the YNB + 0.5％ glucose media,the farnesol level was significantly higher in the standard stains than in the resistant strains (36 hours:2.950 ± 0.677 vs.0.523 ± 0.266,P =0.020).Conclusion The media markedly affect the production of farnesol in the C.albicans biofilms,and there is a certain difference in the production of farnesol between resistant and standard C.albicans strains.

Objective To explore the effect of oris(oral)muscles training on speech language rehabilitation for autism spectrum disorders children.Methods 40 cases were divided into 2 groups,20 cases in each group.The control group was treated with language cognitive training.The observation group was treated with language cognitive combined with oris(oral)muscles training.The treatment was given for 6 months.S -S(sign -significate relationgs) was used to evaluate the language development quotient of the two groups.Results After treatment,the language development quotient was significantly improved compared with before treatment(P <0.05),and the language expres-sion quotient of the observation group was more effective than the control group(t =2.434,P <0.05).The language comprehension quotient and operation quotient of the two groups had no significant differences.Conclusion Oris muscles training combined with language cognitive is more effective on language expression capability of autism spec-trum disorders children.