Clinical difference between single subtype and mixed subtype chronic urticaria: A retrospective study

Background: The subtypes of chronic urticaria share a common clinical expression, but may show differences phenotypically. Meanwhile, two or more different subtypes of chronic urticaria can coexist in any given patient which may involve different phenotypes. Aims: The study aims to compare the two phenotypes in terms of demographics, clinical profile and treatment response. Methods: In this retrospective study, 2678 chronic urticaria patients were divided into the single subtype chronic urticaria group and mixed subtype chronic urticaria group as was appropriate.The differences in the clinical features, possible causes, urticaria activity score of seven days, dermatology life quality index score, laboratory investigations and response to treatments were evaluated among the two groups. Results: An obvious female predominance was detected in chronic urticaria, especially in mixed subtype chronic urticaria patients. Of the 2678 chronic urticaria patients, there were 837(31.25%) mixed subtype chronic urticaria. Chronic spontaneous urticaria combined with symptomatic dermographism was the most common group in the mixed subtype chronic urticaria. Patients with mixed subtype chronic urticaria were more likely to have associated chest tightness/shortness of breath and showed greater urticaria activity. In patients with single subtype chronic urticaria, the positive rate of family history with allergic rhinitis, asthma or urticaria was lower. Based on evaluation of the treatment, control with second-generation antihistamines at licensed doses was achieved in only 38.83% of mixed subtype chronic urticaria patients, compared with 56.32% of patients with single subtype. Limitations: First, this study was a single-center design retrospective study. Second, omalizumab treatment was not included. Third, the differences between different subtypes of mixed subtype chronic urticaria were not discussed in detail. Conclusion: This study showed that mixed subtype chronic urticaria had some distinct features. Comprehensive knowledge about it may help us define effective therapeutic strategies and improve symptom control and the quality of life for chronic urticaria patients

Laparoscopic versus open splenectomy with esophagogastric devascularization for portal hypertension: a Meta-analysis / 中华肝胆外科杂志

Objective To compare the safety and feasibility of laparoscopic splenectomy and esophagogastric devascularization (LS + ED) versus open splenectomy and esophagogastric devascularization (OS + ED) in treating portal hypertension using Meta-analysis.Methods Controlled trials comparing LS + ED and OS + ED in treating portal hypertension were electronically searched from Wan Fang Data Knowledge Service Platform,Medalink,CNKI,PubMed,Elsevier,SpringerLink and CBM disc.The most recent search was conducted in April 2015.All the relevant data and references were retrieved and screened.RevMan 5.2 was used for data analysis.Results Eventually,7 randomized controlled trials (RCTs) or high-quality case-controlled studies involving 468 patients were included into this study.Meta-analysis showed LS reduced blood loss [WMD =214.67,95％ CI 198.74-230.60,P ＜ 0.01],shortened flatus time [WMD =17.72,95％ CI 12.39-23.04,P ＜ 0.01] and postoperative hospital stay [WMD =3.75,95％ CI 3.28-4.23,P ＜ 0.01],while the duration of surgery was shorter in OS (P ＞ 0.05).However,OS was comparable with LS in complication rates.Conclusions Comparing with OS,LS had the advantages of reducing intraoperative blood loss and shortening recovery time after operation.In patients with cirrhosis,portal hypertension and esophageal varices,laparoscopic splenectomy was safe and effective.

Analysis the occurrence and affecting factors of the Cirrhosis and portal hypertension complications after splenectomy / 国际外科学杂志

Objective To research the occurrence of liver cirrhosis and portal hypertension splenectomy treatment,and analyze the risk factors for postoperative complications.Methods Retrospectivly analyzed the clinical data of 390 liver cirrhosis cases from March 2009 to May 2013 who were admitted to department of digestion and vascular surgery,First Affiliated Hospital of Xinjiang Medical University,for splenic resection.Child classification,diabetes,amount of fluid drainage,drainage time,blood loss,emergency surgery,combined with other surgery were alalysised by Logistic regression.Results Among three hundred and ninty cases of splenectomy patients,liver cirrhosis complications occurred in 53 cases (53/390,13.58％).In these 53 cases,45 cases combined diabetes,Child grade A 12 cases,B 22 cases,C 19 cases,and theirs 24 hours drainage volume was (422.45 ±297.09) mL,drainage time was (4.96 ± 1.48) d,blood loss was (874.72 ± 106.19) mL,K value was 0.10 ±0.06,R15 value was 0.27 ±0.016,albumin concentration was (30.09 ±6.87) g/L,Among the rest 337 cases,228 cases were combined diabetes,Child grade A 134 cases,B 129 cases,C 74 cases,and theirs 24 hours drainage volume was (234.06 ± 171.15) mL,drainage time was (3.18± 1.72) d,blood loss was (261.90±98.27) mL,K value was 0.14 ± 0.09,R15 value was 0.19 ± 0.015,albumin concentration was (32.51 ±5.58) g/L.Multivariate regression analysis had indicated that Child grade,drainage volume of 24 hours,drainagetime,and K value were independent factors affecting the occurrence of complications.Conclusion The major risk factors of incidence happen on postoperative complications in cirrhosis and portal hypertension splenectomy are high Chill grading,draining a long time,and 24 hours blood loss,and k value.

Silence of STIM1 attenuates the proliferation and migration of EPCs after vascular injury and its mechanism

OBJECTIVE@#To investigate the effect of stromal interaction molecule 1(STIM1) knockdown on the proliferation and migration of endothelial progenitor cells (EPCs) after vascular injury and its mechanism.@*METHODS@#The rat bone marrow derived EPCs were divided into three groups: adenovirus negative control (group NSC), rat STIM1 adenovirus vector transfection group (group si/rSTIM1) and rat &human recombinant STIM1 adenovirus transfection group (group si/rSTIM1+hSTIM1). The STIM1 expressions in each group were detected by reverse transcription PCR after transfection; the cell proliferation was tested by [(3)H] thymidine incorporation assay ((3)H-TdR); Cell cycle was analyzed by flow cytometry; the cells' migration activity was detected by Boyden assay; Calcium ion concentration was detected by using laser confocal method.@*RESULTS@#48 h later after transfection, the expression level of STIM1 in si/rSTIM1 cells was significantly lower than that in NSC group (0.21 ± 0.12 vs 1.01 ± 0.01, P<0.05); EPCs that stayed in G1 phase in si/rSTIM1 group [(93.31 ± 0.24)%] were significantly more than that in NSC group [(78.03 ± 0.34)%, P<0.05]; EPCs' migration activity in si/rSTIM1 group (10.03±0.33) was significantly lower than that in NSC group: (32.11 ± 0.54, P<0.05); EPCs calcium ion concentration changes in EPCs in si/rSTIM1 group (38.03 ± 0.13) was significantly lower than that in NSC group (98.11 ± 0.34, P<0.05). While there was no significant difference between si/rSTIM1+hSTIM1 group and NSC group on the four indexes above.@*CONCLUSIONS@#Silence of STIM1 attenuates EPCs proliferation and migration after vascular injury, by mediating the calcium ion concentration in EPCs.

Biochemical regulatory mechanism of asiaticoside in preventing and treating stent restenosis / 中国中药杂志

<p><b>OBJECTIVE</b>To discuss whether asiaticosides could effectively reduce the endothelial cell damage as a biochemical modulator, so as to further inhibit the post-stenting intima-media membrane hyperplasia.</p><p><b>METHOD</b>Human aortic smooth muscle cells and aortic fibroblasts were selected and divided into the blank group, the rapamycin group and the asiaticoside group and the rapamycin and asiaticoside group. The expressions of muscle cells and fibroblasts TGF-beta1, Smad7 and I-collagen gene were determined by RT-PCR. The expression quantity of I-collagen protein was assayed by ELISA. The coefficient of drug interaction (CDI) between rapamycin and asiaticoside was calculated. Additionally, 16 Chinese mini-swines were randomly divided into group A and group B. One sirolimus drug-eluting stent of the same type was implanted after the high-pressure pre-expansion of anterior descending artery balloon. After the operation, the group A was intravenously injected with normal saline 30 mL x d(-1). Whereas the group B was intravenously injected with asiaticoside 30 mg x kg(-1) x d(-1)(diluted to 30 mL). The expressions of plasma vWF of the two groups were measured at the 7th and 14th days after the operation. At the 28th day after the operation, tissues of the stented vessel segments were sliced and stained to calculate the vessel area, inner stent area, lumen area and neointima area</p><p><b>RESULT</b>Compared with the control group, the combination group showed significant up-regulation in smooth muscle cells and fibroblast Smad7 gene, down-regulation in TGF-beta, and obvious inhibition of I-collagen gene expression (P < 0.01). As for smooth muscle cells, there was no difference in the expression of I-collagen between the combination group and the rapamycin group, with CDI at 0. 83. As for fibroblasts, there was a significant difference in the expression of I-collagen between the combination group and the rapamycin group (P < 0.05), with CDI at 0.77. Plasma vWF of the group B was significantly lower than that of the group A (P < 0.05) at the 7th and 14th days after the operation. At the 28th day after the operation, no difference was observed in vessel area and stent area between the two groups. However, the lumen area in the group B was significantly larger than that of the group A(P < 0.05), and the neointima area of the group B was significantly smaller than that of the group A (P < 0.05).</p><p><b>CONCLUSION</b>As an effective biochemical modulator for rapamycin, asiaticosides could inhibit TGF-beta expression, significantly decrease the synthesis and secretion of extracellular matrix, further inhibit the post-stenting intima-media membrane hyperplasia and reduce the endothelial cell damage by effectively up-regulate the expression of Smad7 protein.</p>

Degenarative necrosis and calcification of hepatic cycstic echinococcosis / 中华普通外科杂志

Objective To study factors associated with necrosis and calcification of cyst echinococcosis. Methods This study retrospectively analyzed 191 cases of hepatic cycstic echinococcosis admitted from 2005 to 2008 in the First Affiliated Hospital of Xinjiang Medical University Department of General Surgery, possible relevant factors screened were the patients' gender, age, operation frequency, hepatitis, gall stones, calcium of blood serum, multiple hepatic hydatid cyst, biliary fistulae and hepatic cycstic echinococcosis degeneration. Single-factor analysis and multi-factors analysis were conducted. Results The single-factor independent samples t-test showed that age is significantly related to hepatic cycstic echinococcosis degeneration (t = - 2. 455, P = 0. 008). Single factor Chi-square test showed that factors impacting on hepatic cycstic echinococcosis degeneration were multiple hepatic hydatid cyst and the biliary fistulae (x2 = 6. 848, P = 0. 009; x2 = 7. 149, P = 0. 008). The multiple-factor Logistic regression analysis showed that the age, the multiple hepatic hydatid cyst, and biliary fistulae are the related risk factors(x2 =5. 306,P = 0. 021,OR = 1. 665;x2 = 10. 377,P =0. 001,OR =3. 300;x2 = 4.455,P =0. 035, OR =2. 164) of hepatic cycstic echinococcosis patients with cyst echinococcosis degeneration. Conclusions Age, multiple hepatic hydatid cyst and biliary fistulae are the risk factors associated with degenerative necrosis and calcification of hepatic echinococcosis.