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Objective:To explore the correlation between Traditional Chinese Medicine (TCM) syndrome types of Sj?gren syndrome (SS) and blood test parameters, immunological function and disease activity.Methods:A retrospective cross-sectional study was conducted. The clinical data of 242 SS inpatients in the Rheumatology and Immunology Department of Jiangsu Province Hospital of TCM from February 2021 to June 2022 were analyzed retrospectively. We compared the general data (gender, age, course of disease, BMI), blood parameters [WBC, hemoglobin (Hb), PLT, neutrophil count (NEUT), lymphocyte count(LYMPH), neutrophil/lymphocyte ratio (NLR)], immunological indicators (globulin, IgG, IgA, IgM, rheumatoid factor (RF), anti-SSA antibody, anti-SSB antibody, anti-Ro-52 antibody) .The distribution difference of disease activity [Disease Activity Index of Sjogren's syndrome (ESSDAI) and Patient Report Index of Sjogren's syndrome (ESSPRI)], the correlation between each syndrome type and blood routine parameters, immunological indicators and inflammatory indicators was analyzed by binary logistic regression.Results:They were divided into 82 cases of qi yin deficiency syndrome, 61 cases of yin deficiency and fluid deficiency syndrome, 59 cases of yin deficiency and blood stasis syndrome, 32 cases of yin deficiency and heat toxin syndrome, and 8 cases of other syndrome types. Because the number of other syndrome types was small, they were not included in this study. Logistic regression analysis showed that the positive rate of anti SSA antibody was negatively correlated with IgM [ OR (95% CI)=0.570 (0.407, 0.798)] ( P<0.01). The positive rates of anti SSB antibody and anti Ro-52 antibody were negatively correlated with LYMPH [ OR (95% CI)=0.445 (0.223, 0.886), 0.457 (0.224, 0.932), respectively] ( P<0.05). The positive rates of anti SSB antibody and anti Ro-52 antibody were positively correlated with IgG [ OR (95% CI)=1.171 (1.034, 1.325), 1.159 (1.014, 1.325), respectively] ( P<0.05). Qi Yin deficiency syndrome was positively correlated with WBC [ OR (95% CI)=2.590 (1.120, 5.987)] ( P<0.05), and negatively correlated with LYMPH [ OR (95% CI)=0.090 (0.017, 0.470)] and IgA [ OR (95% CI)=0.728 (0.553, 0.959)] ( P<0.05). Yin deficiency and fluid deficiency syndrome were negatively correlated with PLT [ OR (95% CI)=0.991 (0.984, 0.998)], ESSPRI [ OR (95% CI)=0.705 (0.506, 0.983)], ESSDAI [ OR (95% CI)=0.716 (0.534, 0.960)] ( P<0.05). Yin deficiency and blood stasis syndrome was positively correlated with IgA [ OR (95% CI)=1.184 (1.028, 1.363)] ( P<0.05), and negatively correlated with anti SSB antibody positive rate [ OR (95% CI)=0.247 (0.093, 0.659)] ( P<0.05). Yin deficiency heat toxin syndrome was positively correlated with IgA [ OR (95% CI)=1.368 (1.037, 1.803)] ( P<0.05), and negatively correlated with anti SSB antibody positive rate [ OR (95% CI)=0.278 (0.085, 0.909)] ( P<0.05). Conclusion:The level of immunoglobulin, inflammatory index and disease activity of yin deficiency and blood stasis syndrome and yin deficiency and heat toxin syndrome are high, and blood system damage and exocrine gland disease are easy to occur, which can provide clinical basis for the combination of disease and syndrome differentiation and treatment of SS.
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Objective To compare the clinical efficacy of minimally invasive percutaneous pedicle screw fixation and posterior paraspinal muscle space approach pedicle screw fixation for the treatment of thoracolumbar fractures.Methods Retrospectively analyzed the clinical data of 29 patients treated via minimally invasive percutaneous pedicle screw fixation(minimally invasive group) and 28 patients treated via posterior paraspinal muscle space approach pedicle screw fixation(paraspinal muscle approach group) from March 2013 to October 2015.The anterior vertebral height ratio,sagittal Cobb angle,surgical incision,operation time,number of fluoroscopy,intraoperative blood loss and ODI and VAS scores were compared between the two groups.Results All patients were followed up for an average period of 12.6 months (ranged from 6 to 18 months).At the end of 3 days,3 months and 12 months after operation,vertebral sagittal index and Cobb angle of the two groups were significantly recovered compared with the preoperative data(P0.05).The surgical trauma and intraoperative blood loss of patients in the minimally invasive group were significantly lower than those of the paraspinal muscle approach group,while the operation time and fluoroscopy times were significantly higher than those of the paraspinal muscle approach group,and the differences were statistically significant(P<0.05).Conclusion Minimally invasive percutaneous and paraspinal muscle approach pedicle screw fixation are both effective,safe and reliable.Paraspinal muscle approach pedicle screw fixation has shorter operation time and easier operation,while minimally invasive percutaneous pedicle screw fixation has less trauma,less bleeding and faster postoperative recovery.
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<p><b>OBJECTIVE</b>To identify a rare α-thalassemia gene mutation in a family from south China and perform a pedigree analysis and genetic diagnosis of hemoglobin H (HbH) disease caused by this mutation.</p><p><b>METHODS</b>Peripheral blood samples were collected from the family members for analysis of the hematological phenotype and routine test of thalassemia genes. DNA sequencing was carried out for samples that showed genotype and phenotype inconsistency.</p><p><b>RESULTS</b>A rare α-thalassemia *92A>G gene mutation was detected within this family. The proband and his sister were confirmed to have non-deletional HbH disease with α--/αα genotype. The proband's brother was confirmed to have an α-thalassemia trait with the genotype of -α/αα. The proband's father was identified as an α-thalassemia silent carrier with the genotype of αα/αα.</p><p><b>CONCLUSION</b>A rare α-thalassemia *92A>G gene mutation was identified for first time in south China. The description of the basic phenotypic characteristics of α-thalassemia trait and silent carrier caused by this mutation enriches the α-thalassemia gene mutation spectrum in Chinese population and helps in population screening, clinical molecular diagnosis and genetic counseling.</p>