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1.
Journal of Chinese Physician ; (12): 333-337,342, 2021.
Article in Chinese | WPRIM | ID: wpr-884051

ABSTRACT

Objective:To investigate the optimal emergency endoscopy timing in patients with esophagogastric variceal bleeding (EGVB).Methods:The clinical data of patients with EGVB emergency endoscopy in Renmin Hospital of Wuhan University from December 2018 to November 2020 were collected and analyzed. According to the time interval from admission to the start of emergency endoscopy, they were divided into emergency endoscopy group (<6 h, n=115) and early endoscopy group (6-24 h, n=57). The baseline data, clinical efficacy and postoperative situation of the two groups were compared, and the risk factors of 6-week mortality of EGVB emergency endoscopy were analyzed by univariate and multivariate analysis. Results:In terms of baseline characteristics, there were no significant differences in age, gender, causes, shock index, model for end-stage liver disease (MELD) score, charlson complication index (CCI) score, portal hypertension related complications between the two groups ( P<0.05). However, the albumin (ALB) in emergency endoscopy group was significantly lower than that in early endoscopy group ( P<0.001). There were significant differences in Child Pugh grading and Child Pugh score between the two groups ( P=0.002, P=0.001). In terms of endoscopic efficacy, the detection rate of bleeding site in emergency endoscopy group was significantly higher than that in early endoscopy group (90.4% and 73.7%, P<0.05). There was no significant difference in operation duration, immediate hemostasis success rate, 5-day rebleeding rate, rescue treatment demand and 6-week mortality between the two groups ( P>0.05). There was no significant difference in bleeding related death between the two groups ( P>0.05). In addition, there was no significant difference in blood product consumption, intensive care unit (ICU) stay and total hospital stay between the two groups ( P>0.05). Multivariate analysis showed that Child Pugh grade C ( P=0.018), MELD score ( P=0.005) and CCI score ( P=0.001) were independent risk factors for 6-week death outcome of EGVB patients, while emergency endoscopic intervention time was not related to 6-week death outcome ( P=0.5). Conclusions:The efficacy of early endoscopic intervention is no worse than that of emergency endoscopic intervention, except for the identification of bleeding site. Child-Pugh grade C, MELD score, and CCI score are the independent risk factors for 6-week mortality, while the timing of emergency endoscopy is not associate with 6-week mortality in EGVB patients.

2.
Article in Chinese | WPRIM | ID: wpr-882843

ABSTRACT

Anaphylaxis is increasingly in children, which is currently undernotified, underdiagnosed, and undertreated in China.In order to further improved the understanding and management of anaphylaxis, this issue reviews the pathogenesis, triggers and risk factors, clinical diagnosis and management of anaphylaxis, thus offers the recommedations of anaphylaxis in Chinese children based on previous published evidence-based guidelines and practice parameters.Recommendation aims to develop guiding principles for the diagnosis and management of anaphylaxis in children, and provide a framework for the development of new guidelines.

3.
Article in English | WPRIM | ID: wpr-874558

ABSTRACT

An increasing number of studies have recently indicated the important effects of gut microbes on various functions of the central nervous system.However, the underlying mechanisms by which gut microbiota regulate brain functions and behavioral phenotypes remain largely unknown. We therefore used isobaric tags for relative and absolute quantitation (iTRAQ)-based quantitative proteomic analysis to obtain proteomic profiles of the hippocampus in germ-free (GF), colonized GF, and specific pathogen-free (SPF) mice. We then integrated the resulting proteomic data with previously reported mRNA microarray data, to further explore the effects of gut microbes on host brain functions. We identified that 61 proteins were upregulated and 242 proteins were downregulated in GF mice compared with SPF mice. Of these, 124 proteins were significantly restored following gut microbiota colonization. Bioinformatic analysis of these significant proteins indicated that the glucocorticoid receptor signaling pathway and inflammation-related pathways were the most enriched disrupted pathways. This study provides new insights into the pathological mechanisms of gut microbiota-regulated diseases.

4.
Article in Chinese | WPRIM | ID: wpr-879447

ABSTRACT

OBJECTIVE@#Using the method of finite element analysis, to compare the biomechanical properties between the plate deviating from the long axis of the cervical spine and the standard placement of the plate in the anterior cervical fusion surgery.@*METHODS@#A healthy female volunteer was selected and CT scan (C@*RESULTS@#The lower cervical spine (C@*CONCLUSION@#Little effect on the mechanical stability of the cervical spine was anticipated when the anterior cervical plate was not perfectly aligned with the long axis of the cervical spine. If the tilt of the plate in clinical surgery is less than 20°, there is no need to readjust the position of the plate.


Subject(s)
Biomechanical Phenomena , Cervical Vertebrae/surgery , Female , Finite Element Analysis , Humans , Range of Motion, Articular , Reproducibility of Results , Spinal Fusion
5.
China Pharmacy ; (12): 195-200, 2021.
Article in Chinese | WPRIM | ID: wpr-862643

ABSTRACT

OBJECTIVE:To study the inhibitor y effects of cajanonic acid A on 5 kinds of cytochrome P 450(CYP)enzyme,in human liver microsomes in vitro . METHODS :By Cocktail probe substrate method ,50.0,15.0,5.0,1.5,0.5,0.15,0.05 μmol/L cajanonic acid A were added into liver microsomes , and incubated with mixed probe substrates [including phenacetin , dextromethorphan,omeprazole,testosterone and toluenesulfonbutylurea (probe substrates of CYP 1A2,CYP2D6,CYP2C19, CYP3A4,CYP2C9,respectively)]. On the basis of setting up blank group and positive control group [ α-naphthalene brass , quinidine,(+)-N-3-benzyl vanillin ,ketoconazole and sulfabendazole (specific inhibitors of CYP 1A2,CYP2D6,CYP2C19, CYP3A4,CYP2C9,respectively)],using puerarin as internal standard ,UPLC-MS/MS method was adopted to determine the contents of corresponding metabolites (acetaminophen, dextrophane, 5-hydroxy omeprazole , 6 β-hydroxytestosterone, hydroxytolbutamide). The determination was performed on ACQUITY UPLC ® BEH C 18 column,with mobile phase consisted of 0.01% formic acid aqueous solution- 0.01% acetonitrile formic acid (gradient elution )at the flow rate of 0.4 mL/min. The column temperature was 40 ℃,and the sample size was 2 μL. An electrospray ionization source was used to conduct positive and negative ion scanning in the multiple reaction monitoring mode. The data acquisition range was m/z 100-1 200,the collision gas was argon , the atomized gas was nitrogen ,the gas flow rate of the cone hole was 50 L/h,the desorption gas flow rate was 800 L/h,the capillary voltage under positive and negative mode was 2.0, 1.5 kV,and the ion source temperature was 120 ℃,110 ℃, respectively. The desolvent temperature were 400 ℃ and 450 ℃ , respectively. Non linear regression analysis was performed by using Graphpad Prism 5.0 software and IC 50 wascalculated. RESULTS :The linear ranges of above metabolifes were 0.26-8.35,0.36-34.56,0.10-3.09, 3.67-117.37,0.15-4.88 μmol/L(R2>0.99). The limits of quantitation were 0.26,0.36, 0.10,3.67,0.15 μmol/L,respectively. The IC 50 values of specific inhibitors in positive control group to CYP 1A2,CYP2D6, CYP2C19,CYP3A4 and CYP 2C9 in human liver microsomes were all within the acceptable range reported in the literature. The IC50 values of cajanonic acid A to CYP 1A2,CYP2D6 and CYP 3A4 in human liver microsomes were all more than 50 μmol/L,and the IC 50 values of CYP 2C9 and CYP 2C19 were 4.94 and 18.00 μmol/L,respectively. CONCLUSIONS :Cajanonic acid A has no inhibitory effect on CYP 1A2,CYP2D6 and CYP 3A4,but has a certain inhibitory effect on CYP 2C9 and CYP 2C19.

6.
Article in Chinese | WPRIM | ID: wpr-912637

ABSTRACT

Objective:To evaluate the clinical effect of remodeling the dense dermal fiber structure in the suprapical region on the correction of nasal hypertrophy.Methods:A retrospective analysis was carried out in beauty-seeking patients who underwent comprehensive costal cartilage rhinoplasty with nasal hypertrophy in our hospital from September 2016 to February 2018. The technique of horizontal scratch reconstruction and deep dermal suture fixation at the tip of the nose was used to fix the dense fibrous dermal fiber structure in the suprapical area. Photos were followed up 12 months after the operation to observe whether the suprapical area had arch and upward displacement of the nasal tip.Results:All patients healed primarily, and the patients were satisfied with the effects. Follow-up results showed that only one female patient showed upshift of nasal tip after surgery among the 57 patients with hypertrophy of nasal tip for beauty. The remaining 56 patients had no upward movement of the nose tip and arching of the upper turning area.Conclusions:By reshaping the dense dermal fiber structure of the suprapical area, the suprapical area of the patients who seek beauty after the operation will have a natural transition, beautiful shape and stable nasal structure.

7.
Article in Chinese | WPRIM | ID: wpr-912636

ABSTRACT

Objective:To evaluate the advantages of cortical perichondrium retention of costal cartilage in tip plasty.Methods:A total of 618 female cases were retrospectively analyzed from July 2017 to July 2018 in Zhengzhou Meilai Medical Beauty Hospital that underwent comprehensive line of rib cartilage rhinoplasty for beauty, aged 18-52 years with mean 27±6 years. According to different modification graft used in plasty, the cases were divided into reserve costal perichondrium cortex group (experimental group) and simple rib cartilage cortex group (control group). Statistical analyses were carried out 1 month and 12 months after operation. The tip displacement visualization was compared between the two groups and the advantages and disadvantages were evaluated in both.Results:After the surgery of the 618 patients, the rate of displacement in the experimental group was 3.6%, and that in the control group was 7.9% (χ 2=4.95, P<0.05). The rate of the implant exposure in the experimental group was 4.7%, and that in the control group was 9.1% (χ 2=4.38, P<0.05). The reserve costal perichondrium cortex used in the nasoplasty kept the prominent and stable nasal tip after the operation, and longterm follow-up showed there were no displacement and deformation occured in the patients. Conclusions:The application of costal cartilaginous cortex retaining costal perichondrium in tip plasty can obtain good nasal tip protrusion and stable rotation. It is an ideal nasal tip shaping material and worthy of clinical application.

8.
Article in Chinese | WPRIM | ID: wpr-912176

ABSTRACT

Objective:To evaluate deep learning in improving the diagnostic rate of adenomatous and non-adenomatous polyps.Methods:Non-magnifying narrow band imaging (NBI) polyp images obtained from Endoscopy Center of Renmin Hospital, Wuhan University were divided into three datasets. Dataset 1 (2 699 adenomatous and 1 846 non-adenomatous non-magnifying NBI polyp images from January 2018 to October 2020) was used for model training and validation of the diagnosis system. Dataset 2 (288 adenomatous and 210 non-adenomatous non-magnifying NBI polyp images from January 2018 to October 2020) was used to compare the accuracy of polyp classification between the system and endoscopists. At the same time, the accuracy of 4 trainees in polyp classification with and without the assistance of this system was compared. Dataset 3 (203 adenomatous and 141 non-adenomatous non-magnifying NBI polyp images from November 2020 to January 2021) was used to prospectively test the system.Results:The accuracy of the system in polyp classification was 90.16% (449/498) in dataset 2, superior to that of endoscopists. With the assistance of the system, the accuracy of colorectal polyp diagnosis was significantly improved. In the prospective study, the accuracy of the system was 89.53% (308/344).Conclusion:The colorectal polyp classification system based on deep learning can significantly improve the accuracy of trainees in polyp classification.

9.
Article in Chinese | WPRIM | ID: wpr-911996

ABSTRACT

We report a case of congenital accessory scrotum and pseudodiphallia with perineal lipoma. A 7-month-old boy was admitted to Xiamen Children's Hospital for a postnatal perineal mass. Physical examination found a mass of 4 cm×4 cm between the scrotum and anterior edge of the anus, with pigmented and wrinkled skin resembling the scrotum without a testicle. There was also a penis-like swelling on the surface of the mass without a urethral orifice. The penis and scrotum with bilateral testis were normal, as were the other organs. The patient's chromosome was 46,XY. Perineal ultrasound, MRI, and voiding cystourethrogram indicated no association between the mass and the penis, urethra, rectum, and anus. A resection of the mass and penis-like swelling and perineoplasty was performed because the normal penis was found to rotate clockwise about 90 degrees during the operation. The pathology showed that the masses were accessory scrotum and lipoma and the penile-like swelling was a pseudodiphallia without corpus cavernosum. Congenital accessory scrotum and pseudodiphallia with a perineal lipoma are rare. It is essential to clarify the anatomical relationship between the mass and genitourinary tract or anorectum before operation.

10.
Article in Chinese | WPRIM | ID: wpr-911582

ABSTRACT

Objective:To analyze the risk factors for postoperative surgical site infections (SSIs) in patients with Crohn's disease (CD).Methods:This retrospective observational study included CD patients undergoing bowel resection between July 2015 and July 2018. The prevalence and risk factors of SSIs were evaluated. The microbiological evaluation from patients with SSIs was performed by bacterial culture and drug sensitivity test.Results:There were 66 patients suffering SSIs, with 41 incisional SSIs and 32 organ/space SSIs. Multivariate analysis identified the preoperative infliximab therapy ( OR 2.338,95% CI 1.192-4.587, P=0.013), laparoscopic surgery ( OR 0.460,95% CI 0.226-0.936, P=0.013), and preoperative white blood cell ( OR 2.008,95% CI 1.018-3.961, P=0.044) as independent factors for SSIs. Fifty-nine strains of pathogenic bacteria were detected in 66 cases of CD combined with SSIs, including 36 strains of gram-negative bacteria, 5 strains of gram-positive bacteria, and 2 strains of fungi. Escherichia coli and Klebsiella pneumoniae were main G - bacteria, with high resistance to common used antibiotics. Enterococcus faecalis and Enterococcus faecium were main G -. 62.1% of the SSIs grew extended-spectrum β-lactamase (ESBL)-producing pathogens in their bacteria cultures and 37.9% grew non-ESBL microbes. Conclusion:The incidence of SSIs was higher in CD patients. Preoperative infliximab therapy, preoperative white blood cell, and laparoscopic surgery were predictors of SSIs.

11.
Article in Chinese | WPRIM | ID: wpr-910845

ABSTRACT

Objective:To investigate the correlation between serum uric acid level and hyperglycemia.Methods:A medical examination cohort of the staff of our hospital was constructed. From February 1 st, 2011, to December 31 st, 2011, 3 937 staff members without hyperglycemia were selected, and baseline data were collected through a questionnaire survey, physical examination, measurement of blood lipid and blood glucose, assessment of kidney function, and other laboratory tests. The subjects were followed up during the annual physical examination for 7 years, from January 1 st, 2012, to December 31 st, 2018. They were divided into four groups according to serum uric acid level: uric acid<360 μmol/L, 360≤uric acid<420 μmol/L, 420≤uric acid<480 μmol/L, and uric acid≥ 480 μmol/L. With the occurrence of hyperglycemia as the outcome indicator; uric acid level as the observation index; uric acid<360 μmol/L as the control group; and gender, age, body mass index, smoking, hypertension, dyslipidemia as confounding factors, Cox regression was performed before and after adjusting confounding factors to analyze the relationship between different uric acid levels and the incidence of hyperglycemia in the entire sample, in the male staff, and in the female staff. Results:The 7-year cumulative incidence of hyperglycemia in the four groups were 15.7%, 34.0%, 38.8%, and 43.8%, respectively ( Z=148.94, P<0.01). In the male staff, the 7-year cumulative incidence rates in the four groups were 23.4%, 29.9%, 34.7%, and 35.8%, respectively ( Z=11.17, P<0.01). In the female staff, the 7-year cumulative incidence rates in the four groups were 14.2%, 42.5%, 52.2%, and 65.0%, respectively ( Z=141.84, P<0.01. After adjusting for gender, age, body mass index, smoking, hypertension, and dyslipidemia, the risk of hyperglycemia in the 360≤uric acid<420 μmol/L, 420≤uric acid<480 μmol/L, and uric acid≥ 480 μmol/L groups were 1.73 (1.39-2.15), 1.86 (1.42-2.45), and 1.95 (1.34-2.85) times higher than that in the control group (all P<0.05). Among female staff, the risk of hyperglycemia in the 360≤uric acid<420 μmol/L, 420≤uric acid<480 μmol/L, and uric acid≥ 480 μmol/L groups were 2.18 (1.62-2.94), 3.41 (2.24-5.20), and 3.02 (1.69-5.40) times, respectively, and were also higher than those in the control group (all P<0.01). Conclusion:With the increase of serum uric acid level, the risk of hyperglycemia in medical staff increases, which is mainly manifested in female staff.

12.
Article in Chinese | WPRIM | ID: wpr-910090

ABSTRACT

Objective:To investigate the feasibility, effectiveness and safety of ultrasound-guided transperineal prostate biopsy (TPB) with coaxial needle technique, and to improve the pain perception of TPB patients by reducing the number of direct perineal needling.Methods:A total of 200 patients who underwent ultrasound-guided TPB at the first clinical college of Three Gorges University & Yichang Central People′s Hospital from January 2019 to December 2020 were randomly divided into coaxial needle group (coaxial needle positioning puncture, n=100) and traditional group (traditional puncture frame guided repeated transperineal puncture, n=100). Visual analog scale (VAS) was used to evaluate the pain of patients during puncture. The number of samples, time-consuming of puncture, cancer detection rate, VAS pain score and complications between the two groups were compared. Results:The success rate of puncture in the coaxial needle group and the traditional group was 100%, and there was no significant difference in the cancer detection rate between the two groups (48% vs 40%, P>0.05). The average number of samples in the coaxial needle group was larger than that in the traditional group, the average puncture time in the coaxial needle group was less than that in the traditional group, and the average intraoperative VAS score of the coaxial needle group was lower than that of the traditional group, the differences were statistically significant[(14.8±1.8) vs (12.1±1.1), (12.9±1.3)min vs (16.5±1.9)min, (2.6±1.2) vs (4.4±1.4); all P<0.001]. The complication rate of the coaxial needle group was lower than that of the traditional group, the difference was statistically significant (18% vs 39%, P<0.001), the incidences of perineal hematoma and perineal pain in the coaxial needle group were lower than that in the traditional group (1% vs 8%, 8% vs 19%; all P<0.05). Conclusions:Coaxial needle technology for ultrasound-guided TPB can ensure the number of samples and accurate sampling in different areas, significantly reduce the number of direct perineal puncture, improve the pain in the process of puncture, reduce the incidence of postoperative perineal pain, with shorter operation time and fewer complications, which is worthy of clinical promotion.

13.
Journal of Chinese Physician ; (12): 1528-1532,1537, 2021.
Article in Chinese | WPRIM | ID: wpr-909739

ABSTRACT

Objective:To investigate the relationship between thyroid iodine uptake rate, 99Tc m imaging and treatment of Graves' hyperthyroidism with 131I. Methods:132 patients with Graves' hyperthyroidism were analyzed retrospectively. According to the difference of thyroid 24-hour iodine uptake rate, they were divided into group A (≤50%), group B (50%-80%) and group C (≥80%). According to the trend of iodine uptake rate curve, they were divided into peak advance group (6 h/24 h iodine uptake rate ratio >1) and non-peak advance group (6 h/24 h iodine uptake rate ratio≤1). Thyroid 99Tc m imaging was divided into three groups according to quality, including group 1 (≤30 g), group 2 (30-60 g) and group 3 (≥60 g). The therapeutic effects of 131I in different types of patients were compared. Results:132 patients were followed up for 6 months after the first 131I treatment. The total effective rate, total cure rate and uncured rate were 88.6%(117/132), 78.0%(103/132), 22.0%(29/132), respectively. The serum thyroxine levels of patients with different 24-h iodine uptake rates in the three groups after treatment were significantly lower than those before treatment ( P<0.05). The lower the 24-h iodine uptake rate of thyroid, the more significantly the serum total triiodothyronine (TT3), total triiodothyronine (TT4), free triiodothyronine (FT3) and free thyroxine (FT4) levels decreased after treatment, the more obvious the increase of thyroid stimulating hormone (TSH), and the more obvious the treatment effect ( P<0.05). The cure rate (13/29, 44.8%) in the peak advance group was significantly lower than that in the non peak advance group (90/103, 87.4%), with statistically significant difference (χ 2=23.899, P<0.001). There was significant difference in the cure rate among the three groups with different thyroid 99Tc m imaging quality (χ 2=15.502, P<0.001). Conclusions:With the increase of thyroid mass, the higher the 24-h iodine intake rate, the more obvious the peak shift, the lower the cure rate, the higher the non-healing rate, and the lower the incidence of hypothyroidism.

14.
Article in Chinese | WPRIM | ID: wpr-908385

ABSTRACT

Objective:To analyze the clinical characteristics of children diagnosed with systemic lupus erythematosus(SLE)complicated with thrombotic microangiopathy(TMA)for early recognition.Methods:We retrospectively reviewed the clinical records of 14 SLE patients with TMA hospitalized at Shanghai Children′s Medical Center, Shanghai Jiaotong University School of Medicine from December 2005 to October 2020.Results:The incidence of TMA was 5.65%(14/248)of the hospitalized patients with SLE and 7.87%(14/178)of the hospitalized patients with lupus nephritis.Four patients were boys while ten patients were girls.One boy was six years old and other 13 patients were from 11 to 18 years old.Their SLEDAI scores ranged from 14 to 31, and all of them were severe activity.Renal biopsy of 11 patients during TMA course all revealed lupus nephritis(type Ⅳ, n=8; type Ⅳ+ Ⅴ, n=3). These 14 SLE children were diagnosed with TMA within 3 days to 2 months after admission.At the beginning of the hospitalization, only six patients had both anemia and thrombocytopenia, while eight patients only had moderate anemia.All of the patients had obvious hypocomplementemia.Especially in the patients with first onset of SLE without treatment, their serum levels of C3 were less than 0.17 g/L and C4 were less than 0.07 g/L.Moreover, glomerular filtration rates of these patients were lower than that in normal range.The follow-up time were 0.2-11.3 years(median time was 2.6 years). After treatment, six patients obtained complete remission, and five patients obtained partial remission.One patient had sudden death during the 4th plasmapheresis, and the other two patients deteriorated. Conclusion:Children with SLE and TMA are mostly in severe disease activity, and renal pathology is type Ⅳ lupus nephritis.The SLE children with anemia should be paid special attention to the level of serum complement whether they have thrombocytopenia or not.If the level of serum complements decrease obviously, glomerular filtration rates should be monitored closely and schistocytes should be searched repeatedly in the blood smears of the peripheral blood to facilitate the early recognition of TMA.

15.
Article in Chinese | WPRIM | ID: wpr-907907

ABSTRACT

Objective:To summarize the clinical characteristics of neonates with Pierre-Robin sequence (PRS) who received mandibular distraction osteogenesis (MDO), in order to provide a basis for perioperative evaluation and management.Methods:Data of neonates diagnosed with PRS and receiving MDO in the Department of Neonatology, Guangzhou Women and Children′s Medical Center between December 2016 and December 2019 were collected for a retrospective study.According to the types of respiratory support needed before surgery, they can be categorized into 3 groups: the invasive ventilation group, the noninvasive ventilation group, the oxygen therapy/positioning therapy group.According to the usage of sedative and analgesic drugs after surgery, they were categorized into 2 groups: the sedative-analgesic group(Fentanyl Citrate and Midazolam) and the single sedative group(Midazolam alone).Results:A total of 31 children were admitted, 22 cases of whom received MDO at an age of (22.09±8.42) d, including 11 cases in the invasive ventilation group, 5 cases in the non-invasive ventilation group, and 6 cases in the therapy/positioning therapy group before surgery; there was statistical significance in severe respiratory distress (81.8% vs.60.0% vs.0) and feeding difficulties (100.0% vs.80.0% vs.50.0%) among the 3 groups (all P<0.05), while there was no difference in laryngomalacia rate(63.6% vs.20.0% vs.33.3%), non-gain in weight before surgery(81.8% vs.80.0% vs.66.7%), postoperative ventilation duration[(7.5±3.4) d vs.(7.2±5.3) d vs.(6.9±4.1) d]and hospital stay[(36.3±9.3) d vs.(34.1±0.3) d vs.(33.8±7.5) d] (all P>0.05). Among these 22 patients, there were 9 cases in the sedative-analgesic group, and 13 cases in the single sedative group.Compared with the single sedative group, cases in the sedative-analgesic group had significantly lower extubation rate (0 vs.15.4%) and shorter hospital stay[(32.3±5.2) d vs.(39.8±7.3) d], and the difference were statistically significant (all P<0.05). Besides, there were no differences in postoperative ventilation duration[(7.4 ± 3.9) d vs.(7.6 ± 4.2) d]between both groups ( P>0.05). The postoperative remission rate of airway obstruction was 100%. Conclusions:MDO in children in their neonatal period could achieve favorable efficacy.The duration of postoperative ventilator support and hospital stay in children with severe airway obstruction could not be prolonged compared with children with mild obstruction, and postoperative sedation and analgesic management can reduce the extubation rate.

16.
Article in Chinese | WPRIM | ID: wpr-907877

ABSTRACT

Objective:To discuss the safety of oral food challenge test(OFC).Methods:Clinical data of 120 cases with allergic reactions during OFC in Department of Pediatrics, Peking University Third Hospital from October 2015 to October 2019 were retrospectively analyzed.The relationship between sex, type of allergic foods, type of allergic reactions, involved organ system, serum specific IgE and severe allergic reaction were analyzed.Results:Allergic reactions occurred in 120 cases.There were 95 males and 25 females.The age ranged from 2 months to 10 years.All involved allergens included milk protein(47.5%, 57/120 cases), egg white(22.5%, 27/120 cases), wheat(19.2%, 23/120 cases), peanut(6.7%, 8/120 cases), nut(1.7%, 2/120 cases), and others(2.5%, 3/120 cases). The type of allergic reaction: 107 cases (90.8%) of hypersensitivity reaction occurred, with 24 cases (21.7%) of severe hypersensitivity reaction, and 13 cases (9.2%) of delayed hypersensitivity reaction.The involved systems include skin and mucous membrane, respiratory system, cardiovascular system, digestive system and nervous system.The correlation coefficient between serum specific IgE and severe allergic reaction was 0.315.Conclusions:Children with indications of OFC in the admission hospital have a high risk of OFC allergic reaction.Nearly 90% of them are immediate hypersensiti-vities, even anaphylaxis.Anaphylaxis that is caused by OFC and may lead to life risk or even death should be avoided.

17.
Article in Chinese | WPRIM | ID: wpr-907873

ABSTRACT

Objective:To investigate the therapeutic effects of Omalizumab in children suffering from multiple allergic diseases.Methods:All children who developed with multiple allergic diseases and were treated with Omalizumab in Department of Pediatrics, Peking University Third Hospital from September 2018 to December 2020 were retrospectively analyzed.Their gender, age, type of allergic disease, serum total IgE (TIgE) and serum allergen-specific IgE (sIgE) levels before treatment, Omalizumab dosage, therapeutic effect and adverse drug reactions were analyzed.Results:In terms of the 28 children who were treated with Omalizumab, the male/female ratio was 17/11, and the age was (9.6±2.7)years.There were 24 cases of asthma (85.7%), 24 cases of allergic rhinitis (85.7%), 9 cases of food allergy (32.1%), 7 cases of atopic dermatitis (25.0%), and 2 cases of chronic urticaria (7.1%), with 26 cases (92.8%) having more than two kinds of allergic diseases, and 28 children having elevated TIgE or sIgE.TIgE was between 39.5 to 3 826.0 kU/L, and the median was 611 kU/L.After treatment, the frequency of wheezing attacks in 24 children with asthma was reduced, the nasal symptoms in 24 children with allergic rhinitis were alleviated, the skin it-ching in 6 children with atopic dermatitis was alleviated, and 1 case had poor improvement, the symptoms in 2 cases with chronic urticaria were alleviated, 9 children had food allergy and 3 cases reached tolerance.Conclusions:The treatment of allergic diseases in children, apart from asthma, Omalizumab is suitable for allergic rhinitis, atopic dermatitis and chronic urticaria.In the treatment of food allergy, it also has the function of increasing the threshold of food allergen tolerance.There are significant therapeutic benefits in children with multiple allergic diseases or being allergic to multiple allergens.

18.
Article in Chinese | WPRIM | ID: wpr-907870

ABSTRACT

Oral food challenge test (OFC) is necessary for the diagnosis of food allergies, however, this clinical diagnosis method has not been popularized yet in China.Although OFC is very important, the knowledge of it is very insufficient and even biased, which is the root cause of non-standard diagnosis of food allergy and over-dependence on allergen testing.Therefore, the necessity, safety, experiment design and results interpretation of OFC would be elucidated in this paper in order to improve the understanding of OFC.

19.
Article in Chinese | WPRIM | ID: wpr-906396

ABSTRACT

Objective:To investigate the effect of allicin (ALL) on learning and memory ability of rats with vascular dementia (VD) and the possible mechanism. Method:The VD rats induced by modified bilateral common carotid artery occlusion (BCCAO) were randomly divided into the VD group, low- and high-dose ALL (ALL-L and ALL-H) groups, and the sham operation (S) group, with 15 rats in each group. In the ALL-L and ALL-H groups, ALL was injected into the femoral vein at 5 mg·kg<sup>-1</sup> and 20 mg·kg<sup>-1</sup>, respectively, while the same volume of normal saline was injected in the S and VD groups, once a day, for two successive weeks. Morris water maze (MWM) was used to test the learning and memory ability of rats. Hematoxylin and eosin (HE) staining was conducted to observe the pathological changes in hippocampal tissue, followed by the detection of inflammatory factors tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>), interleukin-6 (IL-6), and IL-1<italic>β</italic> as well as oxidative stress indexes malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) in rat hippocampus. The apoptosis of hippocampal cells was detected by TdT-mediated dUTP Nick end Labeling(TUNEL) assay. The expression levels of apoptosis and autophagy-related proteins cysteinyl aspartate-specific protease-3 (Caspase-3), B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X protein (Bax), microtubule-associated protein light chain 3Ⅱ (LC3Ⅱ), LC3Ⅰ, and the mammalian homolog of yeast ATG6 (Beclin 1) in hippocampus were determined by Western blot. Result:The comparison with the VD group revealed that the learning and memory abilities of rats in the ALL-H and ALL-L groups were significantly improved (<italic>P</italic><0.05). The TNF-<italic>α</italic>, IL-6, IL-1<italic>β</italic>, and MDA levels in hippocampus were lowered (<italic>P</italic><0.05), whereas the SOD and GSH-Px activities were enhanced (<italic>P</italic><0.05). The apoptosis rates were declined (<italic>P</italic><0.05), with an even lower rate noticed in the ALL-H group (<italic>P</italic><0.05). The expression levels of Caspase-3, Bax, LC3Ⅱ/LC3Ⅰ ratio, and Beclin-1 in the ALL-H and ALL-L groups were significantly down-regulated in contrast to those in the VD group (<italic>P</italic><0.05), while that of Bcl-2 was up-regulated (<italic>P</italic><0.05). The ALL-H group exhibited better performances than the ALL-L group (<italic>P</italic><0.05). Conclusion:ALL could improve the learning and memory ability of VD rats to some extent, which may be attributed to its inhibition against inflammatory reaction, oxidative stress, and neuronal apoptosis and autophagy.

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Article in Chinese | WPRIM | ID: wpr-906313

ABSTRACT

Objective:To explore the potential molecular mechanism of Nelumbinis Plumula alkaloids (NAPs) in the prevention and treatment of non-small cell lung cancer (NSCLC) based on network pharmacology and cell experiment. Method:The main active components of NAPs were obtained by searching Traditional Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP) and Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine (BATMAN-TCM), and their main targets were predicted and analyzed by employing Swiss Target Prediction. The main target genes of NSCLC were retrieved from GeneCards, Online Mendelian Inheritance in Man (OMIM) and DrugBank databases. The resulting common targets were imported into STRING platform for constructing the protein-protein interaction (PPI) network, followed by gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis based on Database for Annotation, Visualization, and Integrated Discovery (DAVID). The NAPs-common target -pathway network was constructed by Cytoscape 3.7.1. After NSCLC cell line A549 was treated with isoliensinine, the cell morphology was observed under an inverted fluorescence microscope. The effect of isoliensinine on A549 vitality was detected by cell counting kit-8 (CCK-8) assay and the target protein changes were verified by Western blot. Result:The main active components for NAPs against NSCLC were lysicamine, liensinine, and isoliensinine. The phosphatidylinositol-3-kinase-protein kinase B (PI3K-AKT), RAS-related protein 1 (Rap1), epidermal growth factor family of receptor tyrosine kinases (ErbBs), and hypoxia inducible factor-1 (HIF-1) pathways were mainly involved for binding adenosine triphosphate (ATP) and regulating protein kinase activity. The main targets included protein kinase B-1 (AKT1), alpha catalytic subunit of phosphoinositol-3-kinase (PIK3CA), cyclin-dependent kinase 2 (CDK2), mitogen-activated protein kinase-1 (MAPK1), epidermal growth factor receptor (EGFR), adenosine triphosphate-binding cassette B1 (ABCB1), mammalian target of rapamycin (mTOR), tyrosine kinase (Src), Janus kinase 1 (JAK1), and G1-phase-specific gene cyclin-D<sub>1</sub> (CCND1). The <italic>in vitro</italic> cell experiment also revealed that isoliensinine down-regulated the expression of phosphorylated AKT (p-AKT) and phosphorylated mTOR (p-mTOR) in a concentration- and time-dependent manner and inhibited the growth of A549 cells. Conclusion:NAPs exert the preventive and therapeutic effects against NSCLC through multiple components, multiple targets, and multiple pathways, especially the PI3K-AKT pathway.

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