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Objective:To explore the application effect of a new type of simulated dermatologic surgical mold based on 3D printing in standardized residency training of dermatology.Methods:In this study, 35 residents in Department of Dermatology, The Second Affiliated Hospital of Guangzhou Medical University from January 2018 to May 2019 were randomly divided into two groups: a new mold group based on 3D printing ( n=18) and a traditional mold group ( n=17). Two groups of residents were examined by dermatologic biopsy on the mold, and the effect of teaching was evaluated by questionnaire survey. SPSS 22.0 was used for data analysis, and the measurement data was expressed by (means ± standard deviation). The comparison between the new mold group and the traditional mold group was made by two independent samples t test. Results:The scores of dermatologic biopsy examination of residents in the new mold group were higher than those in the traditional mold group, and the differences were statistically significant ( P<0.01); and the scores of the questionnaires for the teaching effect of the new mold group were higher than those of the traditional mold group, and the differences were statistically significant ( P<0.01). Conclusion:The new type of simulated dermatologic surgical mold based on 3D printing, which has been successfully applied in the practical training of residents, lays a solid foundation for the actual clinical operation and significantly improves the teaching effect, providing a broad application prospect.
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Objective:To compare the detection rate of genital Chlamydia trachomatis (CT) DNA between urine and urethral/cervical swab samples. Methods:From December 2018 to December 2019, a total of 1 475 outpatients were collected from sexually transmitted disease clinics in 7 medical institutions, such as Department of Venereology, Guangzhou Institute of Dermatology, including 1 118 males and 357 females. One urethral/cervical swab sample and one urine sample were collected successively from each patient. Real-time fluorescence-based PCR was performed to detect CT DNA in urine and urethral/cervical swab samples, and paired chi-square test was used to compare the positive rate of CT DNA between the 2 kinds of samples. Random- or fixed-effect meta-analysis was conducted for the test of heterogeneity and merging of positive rates of CT DNA in the urine and urethral/cervical swabs among 7 medical institutions.Results:The positive rate of CT DNA in the urine samples was significantly higher than that in the swab samples from 4 medical institutions (all P < 0.05) , while there was no significant difference in the positive rate of CT DNA between the 2 kinds of samples from 3 medical institutions (all P > 0.05) . The heterogeneity ( I2) estimates of the CT-DNA positive rate in urine and swab samples among different medical institutions were 78.6% (95% CI: 55.9% - 89.6%) and 73.7% (95% CI: 43.7% - 87.7%) , respectively; meta-analysis showed that the total merged positive rate of CT DNA in the urine samples was 10.8% (95% CI: 7.2% - 15.9%) , which was significantly higher than that in the swab samples (7.8%, 95% CI: 4.9% - 12.1%; χ2 = 39.2, P < 0.05) . Compared with the swab sample-based CT-DNA detection method, the sensitivity, specificity, positive predictive value, negative predictive value and consistency rate of the urine sample-based CT-DNA detection method were 97.0% (128/132) , 96.3% (1 293/1 343) , 71.9% (128/178) , 99.7% (1 293/1 297) , and 96.3% (1 421/1 475) , respectively. The positive rate of CT DNA in the urine samples from 1 118 male patients was 11.0% (95% CI: 7.2% - 16.5%) , which was significantly higher than that in the swab samples (7.6%, 95% CI: 4.9% - 11.8%; χ2 = 34.3, P < 0.05) . There was no significant difference in the positive rate of CT DNA between the urine (11.9%, 95% CI: 7.7% - 17.9%) and cervical swab samples from 357 female patients (10.4%, 95% CI: 7.6% - 14.0%; χ2 = 3.2, P > 0.05) . Conclusions:The positive rate of CT DNA in urine samples is higher than or similar to that in urethral/cervical swab samples. The urine sample-based CT-DNA detection method has characteristics of convenience, non-invasiveness, painlessness and low cost, and is worthy of clinical promotion.
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Objective To investigate the nutritional support of hospitalized patients with advanced lung cancer in Shanghai. Methods From July 2018 to May 2020, hospitalized patients with advanced lung cancer in our hospital were selected. Patients were assessed using general situation questionnaire and patient subjective evaluation scale. The experimental indicators of patients were detected, the nutritional support was analyzed, and the risk factors of nutritional status of patients with lung cancer were analyzed. Results Among the 106 patients, 75 were male and 31 were female, 74 were under 64 years old and 32 were over 65 years old; PG-SGA results revealed that 37 cases (34.91%) scored 0~1, 48 cases (45.28%) scored 2-8, and 21 cases (19.81%) scored equal to or above 9; According to PG-SGA classification, patients were divided into good nutrition group (n=37) and malnutrition group (n=69). The proportion of patients of ≤64-year-old, TNM stage IV, WBC and neutrophil count in good nutrition group was lower than that of malnutrition group (P<0.05), meanwhile, the KPS, body mass index, red blood cell count, lymphocyte count, hemoglobin, serum protein, albumin, immunoglobulin IgG, IgM, IgA, CD4 +, CD3 +, and CD8 + were higher than those of malnutrition group (P<0.05). Logistic analysis showed that age ≥ 64 years old, TNM stage IV, KPS and BMI were risk factors of nutritional status (P<0.05). Conclusion Among the patients with advanced lung cancer in Shanghai, the incidence of malnutrition is 65.09%, and 19.81% of those with severe malnutrition are in urgent need of nutritional support. Logistic analysis results yield that age over 64 years old, TNM stage Ⅳ, KPS, body mass index are risk factors affecting nutritional status of patients.
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Psoriasis is considered as an inflammatory disease driven by T cells, and its pathogenesis is closely related to the imbalance of intestinal bacteria flora. It has been reported that Bacteroides fragilis could play an anti-inflammatory role by regulating the expression of cytokines in T cells. To date, there is no report using B. fragilis to treat psoriasis. In this study, we explored the therapeutic effect of B. fragilis BF839 on psoriasis. We selected 27 psoriasis patients who were treated in the Second Affiliated Hospital of Guangzhou Medical University from April to October 2019. The patients were given B. fragilis BF839 orally for 12 weeks while maintaining the original treatment. The psoriasis area and severity index (PASI) score was evaluated before and after the treatment. The rate of drug withdrawal and reduction after 12 weeks of treatment were calculated. Our results showed that the rate of 12-week trial completion was 96.3% (26/27). We used PASIN to define the proportion of people whose PASI score decreased more than or equal to N% after treatment. At 12 weeks, PASI30, PASI50, and PASI75 were 65.4%, 42.3%, and 19.2%, respectively. The PASI score was 9.1±5.9 and 5.8±4.9 before and after 12 weeks of treatment respectively, and the difference was statistically significant (P0.05). The adverse reaction rate of patients was 3.8% (1/26) within 12 weeks of treatment, including 1 case of constipation, and the rate of drug withdrawal and reduction was 60.0%. The above results suggest that B. fragilis BF839 may be functional on the treatment of psoriasis by reducing the PASI score and the drug usage rate with few side effect, which deserves further study.
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Humans , Anti-Inflammatory Agents , Bacteroides fragilis , Cytokines , Psoriasis/drug therapy , Severity of Illness Index , Treatment OutcomeABSTRACT
Objective To explore the indicators change of early renal injury in patients with chronic obstructive pulmonary disease (COPD) and its clinical significance.Methods Ninety cases of COPD including 45 cases with stable period of COPD,45 cases with acute exacerbation of COPD who received treatment in Baoshan Branch of Shanghai General Hospital from January 2014 to December 2014 were enrolled in this study.Meanwhile 45 cases of healthy subjects were collected as the control group.According to the extent of hypoxia,the COPD patients were divided into mild subgroups (60mmHg
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Objective·To observe changes of exhaled nitric oxide (FeNO) level in patients with chronic obstructive pulmonary disease (COPD) before and after inhaled corticosteroid (ICS) therapy and to explore the correlation of FeNO level with inflammation and pulmonary function indexes. Methods·Seventy COPD patients at stable stage who underwent ICS therapy (the COPD group) were enrolled. Levels of peripheral blood eosinophil (Eos) and neutrophil (N), FeNO, PEF, FEV1 and FEV1/pred before and after treatment were measured. Fifty healthy volunteers who received physical examination at the same time served as controls (the control group). The relationship between these indexes and clinical efficacy and the correlation between FeNO level and inflammation or pulmonary function indexes were analyzed. Results·The COPD group had significantly higher FeNO, Eos, and N levels before treatment, significantly lower PEF, FEV1 and FEV1/pred after treatment (P0.05). Conclusion·The FeNO level increased significantly in patients with COPD at stable stage and is a sensitive index of airway inflammation. Combined with lung function test, it's useful for evaluating the efficacy of ICS and guiding treatment.
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Objective To detect serum levels of 25 ? hydroxyvitamin D (25 [OH] D) and matrix metalloproteinase 9(MMP?9)in patients with chronic spontaneous urticaria(CSU), and to explore their significance. Methods Totally, 56 patients with CSU and 25 healthy controls were enrolled into this study. High?performance liquid chromatography tandem?mass spectrometry(LC?MS/MS)and enzyme?linked immunosorbent assay(ELISA) were performed to measure serum levels of 25(OH)D and MMP?9 respectively in these subjects. Statistical analysis was carried out by two independent samples t?test or Wilcoxon rank sum test for comparisons of the above indexes between the two groups, and by Spearman rank correlation analysis for assessment of relationships between the serum levels of 25(OH)D and MMP?9 as well as between the two indexes and disease severity. Results Of the 56 patients, 19 were diagnosed with mild CSU, 26 with moderate CSU and 11 with severe CSU. Compared with the control group, the patient group showed significantly lower serum levels of 25(OH)D(21.74 ± 6.04 vs. 30.17 ± 2.21μg/L, P0.05);the serum level of MMP?9 was positively correlated with the severity of CSU(rs=0.27, P<0.05). Conclusion Vitamin D and MMP?9 may play a role in the occurrence of CSU.
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Objective To measure the expressions of programmed death?1(PD?1)and programmed death ligand?1(PD?L1)on peripheral blood T lymphocytes of patients with condyloma acuminatum(CA), and to investigate their role in cellular immunity in these patients. Methods Peripheral blood samples were obtained from 30 patients with CA(CA group)and 20 healthy human controls (control group). Flow cytometry was conducted to detect the expressions of PD?1 and PD?L1 on the surfaces of peripheral blood CD4+and CD8+T lymphocytes, and to determine the counts of CD4+and CD8+T lymphocytes. Enzyme?linked immunosorbent assay(ELISA)was performed to measure the levels of serum interleukin?2(IL?2)and interferon?γ(IFN?γ). Statistical analyses were carried out to compare the above parameters between the two groups, and to assess the relationship of PD?1 and PD?L1 expressions with the counts of CD4+and CD8+T lymphocytes as well as with the serum levels of IL?2 and IFN?γ. Results There was a significant increase in the expression rates of PD?1 and PD?L1 on CD4+T lymphocytes(PD?1:9.48%± 3.31%vs. 7.12%± 2.16%, t=2.81, P0.05). The levels of serum IL?2 and IFN?γwere both lower in the CA group than in the control group(t=2.12, 2.16, respectively, both P 0.05). Conclusion PD?1 was highly expressed on peripheral blood T lymphocytes from patients with CA, which may inhibit T lymphocyte?mediated immune response, decrease CD4+T lymphocyte counts, the CD4/CD8 ratio as well as IL?2 and IFN?γserum levels by interacting with its ligand PD?L1 and forming the PD?1/PD?L1 signaling pathway.
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Objective To investigate the relationship between negative acute phase proteins and chronic urticaria (CU).Methods Fifty patients with CU were enrolled into this study,and divided into three grades,i.e.,mild (grade 1),moderate (grade 2) and severe (grade 3) according to symptoms.Twenty-eight health checkup examinees served as the control group.Immunoturbidimetry was performed to determine serum levels of prealbumin (PA) and transferrin (TRF).Enzyme-linked immunosorbent assay was conducted to measure serum levels of insulinlike growth factor-1 (IGF-1) and tumor necrosis factor-α (TNF-α).Statistical analysis was carried out to assess differences in these indices between these two groups,the relationship among these indices and between these indices and disease severity.Results Compared with the control group,the patients with CU showed reduced serum levels of PA ((229.99 ± 54.16) vs.(272.06 ± 36.42) mg/L,t =3.667,P ＜ 0.05) and IGF-1 ((177.23 ± 46.48) vs.(239.88 ± 45.16) μg/L,t =5.748,P＜ 0.05),but higher serum levels of TNF-α ((25.39 ± 11.01) vs.(14.13 ± 6.12) ng/L,t =4.989,P＜ 0.05),and similar serum levels of TRF ((2.48 ± 0.49) vs.(2.48 ± 0.25) g/L,P＞ 0.05).The serum level of PA showed a significant negative correlation with that of TNF-α (r =-0.312,P ＜ 0.05),as well as with disease severity (r =-0.635,P ＜ 0.01),whereas the serum level of TNF-α showed a significant positive correlation with disease severity (r =0.409,P ＜ 0.01),and no statistical correlation was found between the remaining indices (all P ＞ 0.05) in the patients with CU.Conclusions Serum levels of some negative acute phase proteins decrease and negatively correlate with disease severity in patients with CU.Acute phase response may be involved in the occurrence of CU.
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Objective To evaluate the relationship of acute-phase response and coagulation/fibrinolysis with chronic urticaria (CU).Methods Fifty-three patients with CU and twenty-five healthy human controls were enrolled in this study.Venous blood samples were collected from all of these subjects.Then,enzyme-linked immunosorbent assay was carried out to measure the serum levels of interleukin-6 (IL-6) and amyloid protein A (AA),and immunoturbidimetry to determine the levels of serum high sensitive C-reactive protein (Hs-CRP) and plasma D-dimer.The patients with CU were classified into three groups according to the severity of clinical symptoms.The levels of serum IL-6 and plasma D-dimer were given in mean ± standard deviation,and those of serum AA and Hs-CRP in mean (25th percentile,75th percentile).Rank sum test and t test were performed to compare these parameters between the patients and controls,and Spearman rank correlation analysis was conducted to study the relationship among these parameters as well as between these parameters and symptom severity in these patients.Results The levels of serum IL-6,serum AA and plasma D-dimer were (10.70 ± 4.94) ng/L,4.92 (8.22,12.51) μg/L,and (222.32 ± 163.69) μg/L respectively in the patients with CU,significantly higher than those in the healthy controls ((7.49 ± 3.41) ng/L,2.11 (1.21,2.83) μg/L,(104.72 ± 43.12) μg/L,respectively,all P＜ 0.05),while no significant differences were observed between the patients and controls in the level of serum HsCRP (0.30 (0.10,1.40) mg/L vs.0.30 (0.10,0.55) mg/L,P ＞ 0.05).In patients with CU,the levels of serum IL-6 were unrelated to those of serum Hs-CRP,serum AA,or plasma D-dimer (all P ＞ 0.05),whereas a positive correlation was observed between the levels of serum Hs-CRP and AA (r =0.67,P ＜ 0.01),serum Hs-CRP and plasma D-dimer (r =0.49,P ＜ 0.01),serum AA and plasma D-dimer (r =0.38,P ＜ 0.01).Further more,the levels of serum Hs-CRP,AA and plasma D-dimer were significantly correlated with symptom severity in patients with CU (r =0.63,0.62,0.47,respectively,all P ＜ 0.01).Conclusions Acute-phase response coexists with the activation of coagulation system in patients with CU,suggesting a potential association between acute-phase response and coagulation system activation.
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Objective To evaluate the intestinal barrier function of the patients by two-sugar absorption test with high performance liquid chromatography (HPLC). Methods Nineteen children with confirmed food hypersensitivity (FH) and 19 normal children were included in this study. The average age was (8.1?1.7) months. After 8-hour fasting, subjects drank test solution (5 g lactulose and 2 g mannitol per 100 ml) at the dose of 2 ml/kg. Five-hour urinary excretion ratio of lactulose/mannitol (L/M) were measured using high performance liquid chromatography (HPLC). The condition of HPLC was as follows: Sugar-PakI column with refractive index detector; Mobile phase: pure deionized water; Flow rate: 0.5 ml/min; temperature of column: 85 ℃. Results HPLC chromatogram of urine sample was stable. The retention time of mannitol and lactulose was 13.86 min and 9.27 min respectively. A significant rise in 5 h urinary L/M excretion ratios was found in children with FH (0.18?0.06) as compared to that of controls (0.05?0.03) (P
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Objective To explore the possible causes that result in serum-resistance of patients with syphilis. Methods Cerebrospinal fluid(CSF) routine and biochemistry, RPR, TPPA, and immunological function in 25 patients with syphilis serum-resistance were detected after giving the standard therapy, and radiographic examination of multiple internal organs was performed as well. All patients were treated with 24 million units of Penicillin G per day by intravenous drip for 14 days followed by muscle injection of Bicillin 2.4 million units weekly for 3 weeks after leaving hospital. Blood serum RPR was reexamined 3 and 6 months after treatment, respectively. Results Among 25 patients CSF-TPPA was positive in 11 cases, all patients' CSF-RPR were negative, CSF-WBC and CSF-Pr increased in 7 patients, serum IgM level increased and C3 decreased in 10 cases (40%), and CD_3+CD_8+ cell count increased and NK cell count decreased in 21 cases (84%). The regurgitation of bicuspid valve, tricuspid valve and aortic value was found in 3 patients. The RPR titers in all patients did not decrease after treatment according to neurosyphlis. Conclusion Asymptomatic neurosyphilis and immune disorder may be causes of serum-resistance of syphilis.