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Objective:To investigate the efficacy of montelukast sodium combined with methylprednisolone in the treatment of pediatric allergic purpura and its effects on inflammatory factors and immune function.Methods:A total of 94 children with allergic purpura who received treatment in Taizhou Women and Children's Hospital and Taizhou Hospital Medical Center (Group) Enze Hospital from March 2019 to March 2021 were included in this study. They were randomly divided into observation and control groups ( n = 47/group). The control group was treated with methylprednisolone. The observation group was treated with montelukast sodium combined with methylprednisolone. The course of treatment was 2 weeks in both groups. Efficacy and changes in inflammatory factors and immune function post-treatment relative to those pre-treatment were compared between the two groups. Results:Total response rate in the observation group [93.62% (44/47)] was significantly higher than that in the control group [74.47% (35/47), Z = 2.15, P < 0.05)]. After treatment, interleukin (IL-4), IL-6, and IL-18 levels in each group were significantly decreased compared with those before treatment ( tobservation group = 21.19, 22.26, 27.20, tcontrol group = 11.10, 13.21, 14.86, all P < 0.05). After treatment, IL-4, IL-6, and IL-8 levels in the observation group were (48.98 ± 5.21) ng/L, (34.10 ± 6.42) ng/L, and (53.29 ± 5.67) ng/L, respectively, which were significantly lower than (65.38 ± 7.08) ng/L, (47.83 ± 4.71) ng/L, (67.83 ± 7.10) ng/L in the control group ( t = 12.79, 11.82, 10.97, all P < 0.05). After treatment, CD3 +, CD4 +, and CD4 +/CD8 + in each group were significantly increased compared with those before treatment ( tobservation group = 14.27, 14.41, 17.61, tcontrol group = 6.90, 5.12, 7.40, all P < 0.05). After treatment, CD3 +, CD4 +, and CD4 +/CD8 + in the observation group were (68.94 ± 2.89)%, (39.94 ± 2.15)%, and (1.79 ± 0.13), respectively, which were significantly higher than (63.86 ± 3.28)%, (35.65 ± 2.31)%, and (1.53 ± 0.16) in the control group ( t = 7.96, 9.32, 8.64, all P < 0.05). After treatment, serum IgG and IgM levels in each group were significantly decreased compared with those before treatment ( tobservation group = 21.00, 7.99, tcontrol group = 8.38, 5.76, both P < 0.05). After treatment, serum IgG and IgM levels in the observation group were (1.43 ± 0.19) g/L and (9.74 ± 0.78) g/L, respectively, which were significantly lower than (1.95 ± 0.37) g/L and (10.89 ± 0.85) g/L in the control group ( t = 8.57, 6.83, both P < 0.05). Conclusion:Montelukast sodium combined with methylprednisolone is highly effective on allergic purpura in children. The combined therapy can reduce inflammatory responses and improve immune function in children.
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Objective@#To explore the feasibility of real-time three-dimensional ultrasound Xplane imaging in quantifying left and right atrial diastolic maximal volume (LAVmax, RAVmax) and evaluating cardiac diastolic function in fetuses with cardiac disease in second and later trimesters.@*Methods@#One hundred and forty-four fetuses with abnormal heart morphology at 16-34 weeks of gestational age were included and divided into 3 groups according to the influence of pathological changes on atrial volume: group A with symmetrical left and right atrial volume, group B with decreased left atrial volume and increased right atrial volume and group C with increased left atrial volume and decreased right atrial volume, and the fetus were also divided into 2 groups according to the law of fetal development: the middle pregnancy group (16-27+ 6 weeks) and the late pregnancy group (28-34+ 6 weeks). Using the " Xplane" mode of volume probe, the maximal atrial volume was calculated automatically by tracing method and three-path line method. The correlation between the two methods in quantitative LAVmax was validated by paired sample t test and Pearson correlation analysis. The correlation between LAVmax, RAVmax and gestational age were analyzed by curve fitting. The volumes of bilateral chambers and the average weekly growth rates of E peak, A peak and E/A value of mitral and tricuspid orifices were calculated and compared.@*Results@#There was no significant statistical difference between the maximal volume of the left atrium obtained by the tracing method and the three-diameter line method (P>0.05), and there was high correlation between the two methods in the comparison of the maximal volume of the left atrium (r=0.90, 0.88, 0.85; all P<0.01). The data of group A, B and C showed that LAVmax and RAVmax could increase with the increase of gestational weeks in a certain period of abnormal state, and had a good correlation with them(LAVmax: r=0.78, 0.74, 0.78, all P<0.005; RAVmax: r=0.79, 0.77, 0.78, all P<0.005). The average weekly growth rate of RAVmax showed an advantage in group A, B and C. Especially in group C with reduced right atrium, the growth rate of right atrium was 8.15%, which was higher than that of group B with decreased left atrium by 5.06%. The weekly growth rates of E peak and E/A in tricuspid orifice were also higher than those in mitral orifice. The E peak and E/A values of tricuspid orifice in group C were 4.05% and 0.60%, respectively, higher than those in group B, which were 2.58% and 0.02%. Peak A showed an increase in growth rate in group B and group C with decreased atria, peak A values in group B and group C increased by 4.01% and 2.19%, respectively.@*Conclusions@#The right ventricular dominance of fetal heart can still be reflected in certain stages of disease, and the atrial active systolic may play a regulatory role in the filling of cardiac blood flow. Real-time three-dimensional ultrasound Xplane imaging could be used to quantify the atrial volume of fetuses with abnormal heart morphology in second and later trimesters and to preliminary assess atrial function combined with the changes of atrioventricular valve orifice hemodynamics. Real-time three-dimensional ultrasound Xplane imaging technology has obvious advantages of simple, safe, non-invasive, simultaneous and high repeatability in measuring fetal atrial volume.
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Objective To explore the feasibility of real-time three-dimensional ultrasound Xplane imaging in quantifying left and right atrial diastolic maximal volume (LAVmax,RAVmax) and evaluating cardiac diastolic function in fetuses with cardiac disease in second and later trimesters.Methods One hundred and forty-four fetuses with abnormal heart morphology at 16-34 weeks of gestational age were included and divided into 3 groups according to the influence of pathological changes on atrial volume:group A with symmetrical left and right atrial volume,group B with decreased left atrial volume and increased right atrial volume and group C with increased left atrial volume and decreased right atrial volume,and the fetus were also divided into 2 groups according to the law of fetal development:the middle pregnancy group (16-27+6 weeks) and the late pregnancy group (28-34+6 weeks).Using the "Xplane" mode of volume probe,the maximal atrial volume was calculated automatically by tracing method and three-path line method.The correlation between the two methods in quantitative LAVmax was validated by paired sample t test and Pearson correlation analysis.The correlation between LAVmax,RAVmax and gestational age were analyzed by curve fitting.The volumes of bilateral chambers and the average weekly growth rates of E peak,A peak and E/A value of mitral and tricuspid orifices were calculated and compared.Results There was no significant statistical difference between the maximal volume of the left atrium obtained by the tracing method and the three-diameter line method (P ＞0.05),and there was high correlation between the two methods in the comparison of the maximal volume of the left atrium (r =0.90,0.88,0.85;all P ＜0.01).The data of group A,B and C showed that LAVmax and RAVmax could increase with the increase of gestational weeks in a certain period of abnormal state,and had a good correlation with them(LAVmax:r =0.78,0.74,0.78,all P ＜0.005;RAVmax:r =0.79,0.77,0.78,all P ＜0.005).The average weekly growth rate of RAVmax showed an advantage in group A,B and C.Especially in group C with reduced right atrium,the growth rate of right atrium was 8.15 ％,which was higher than that of group B with decreased left atrium by 5.06％.The weekly growth rates of E peak and E/A in tricuspid orifice were also higher than those in mitral orifice.The E peak and E/A values of tricuspid orifice in group C were 4.05％ and 0.60％,respectively,higher than those in group B,which were 2.58％ and 0.02％.Peak A showed an increase in growth rate in group B and group C with decreased atria,peak A values in group B and group C increased by 4.01 ％ and 2.19％,respectively.Conclusions The right ventricular dominance of fetal heart can still be reflected in certain stages of disease,and the atrial active systolic may play a regulatory role in the filling of cardiac blood flow.Real-time three-dimensional ultrasound Xplane imaging could be used to quantify the atrial volume of fetuses with abnormal heart morphology in second and later trimesters and to preliminary assess atrial function combined with the changes of atrioventricular valve orifice hemodynamics.Real-time three-dimensional ultrasound Xplane imaging technology has obvious advantages of simple,safe,non-invasive,simultaneous and high repeatability in measuring fetal atrial volume.
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Objective Toanalyzedrugfreeforpatientswithseverementalillnessandfollow-upof82cases, inordertoprovidebasisforthedivisionoffreedelivery.Methods 82severementalillnesspatientswhowereincon-formity with the conditions of rescue,were given free drug and followed up for 2 years.Before the admission and fol-lowed up for 2 years,the social function evaluation(SDSS)and compliance were evaluated,the recurrence rate was compared.Results Comparisonofcompliance:beforetheadmission,thecompletecompliancein33cases,thepartial compliance in 27 cases,22 cases of non-compliance;After 2 years follow-up,the complete compliance in 52 cases, the partial compliance in 21 cases,9 cases of non-compliance.The difference was statistically significant(u=3.34, P<0.01).Comparison of social function:social withdrawal:before the admission (1.32 ±0.75)points,after 2 years follow-up (0.96 ±0.34)points,the difference was statistically significant(t=3.93,P<0.001 );Family activities:before the admission (1.44 ±0.69)points,after 2 years follow-up (0.87 ±0.31)points,the difference was statisti-cally significant (t=6.78,P<0.001);Personal care:before the admission (1.29 ±0.68)points,after 2 years follow-up (0.95 ±0.62)points,the difference was statistically significant(t=3.33,P<0.001);Interest in the outside world:before the admission (1.23 ±0.63)points,after 2 years follow-up (0.97 ±0.41)points,the difference was statistically significant(t=3.05,P<0.025);The total score:before the admission (15.42 ±7.23)points,after 2 years follow-up (9.56 ±6.89)points,the difference was statistically significant(t=5.28,P<0.001).Compari-son of the recurrence rate:2 years before the admission,the recurrence in 33 cases (40.2%),after 2 years follow-up the recurrence in 15 cases(18.3%),the difference was statistically significant (χ2 =10.64,P<0.001).Conclusion Drug free for patients with severe mental illness and follow-up can improve the social function and the implementation of free administration of patients with severe mental illness,and reduce the recurrence rate and improve compliance.
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Objective To explore the influence of EGFR gene interfering on the radiosensitivity of esophageal squamous cells.Methods Three kinds of siRNAs including three random sequences of positive EGFR siRNA (EGFR siRNA1、EGFR siRNA2、EGFR siRNA3),random sequence of negative EGFR siRNA,and blank control were transfected into Eca109 cells by lipofectamine.Cell proliferation was detected by Cell Counting Kit-8 assay.Protein and mRNA expressions of EGFR were detected by Western blot and RT-PCR,respectively.The ability of cell clone formation was used to evaluate the combination effect of X-rays and EGFR siRNA on the radiosensitivity.Results The positive expression rate of the EGFR mRNA in the Eca109 ceils transfected with EGFR siRNA1,EGFR siRNA2,EGFR siRNA3 was 26.74％,9.52％,4.61％,respectively,which was significantly lower than 42.44％ in the control cells transfected with blank siRNA (F =112.11,P ＜ 0.01).Meanwhile,the EGFR protein expression was reduced by 72.84％,53.01％ and 56.21％ after interfering of siRNA1,siRNA2,and siRNA3,respectively.CCK8 assay showed that the proliferation of Eca109 cells was decreased by 28.2％ since the siRNA interference.Moreover,the D0,Dq and SF2 of the combined treatment group were lower than those of irradiation alone group and the sensitization enhancement ratio was 1.50.Conclusions EGFR siRNA can effectively inhibit EGFR gene expression and enhance the radiosensitivity of Eca109 cells.