Clinical efficacy and safety of secukinumab in the treatment of seven cases of erythrodermic psoriasis / 中华皮肤科杂志

Objective:To evaluate clinical efficacy and safety of secukinumab in the treatment of erythrodermic psoriasis.Methods:From July 2019 to August 2021, 7 patients with erythrodermic psoriasis, who received subcutaneous injection of secukinumab at a dose of 300 mg once a week from week 0 to 4 followed by every-4-week dosing in Wuhan Hospital of Integrated Traditional Chinese and Western Medicine, were collected. At weeks 0, 4, 8 and 12, the psoriasis area and severity index (PASI) was recorded, and adverse drug reactions were observed.Results:All 7 patients were treated for at least 12 weeks. After 4-week treatment, 4 patients achieved PASI50; after 12-week treatment, 5 achieved PASI75, and 2 achieved PASI90. No serious adverse drug reactions occurred. One patient developed fever during the treatment, but the body temperature returned to normal after management; another 1 developed cough and expectoration, and the symptoms were relieved after oral administration of a Chinese herbal preparation named pharyngitis mixture.Conclusion:Secukinumab is effective in the treatment of erythrodermic psoriasis, with fewer adverse reactions, which provides a new option for the treatment of erythrodermic psoriasis.

Advances inbiomarkers for immune thrombocytopenia / 中国输血杂志

Immune thrombocytopenia (ITP) is an autoimmune disease mediated by acquired immunity, with platelets decreased and hemorrhage being the primary clinical manifestations. The responses and platelet count levels after early treatment are important factors affecting long-term prognosis, however, current diagnostic methods and disease evaluation approaches are limited, and lack of specific biomarkers. In recent years, various biomolecules have been proposed as potential biomarkers for ITP. This paper reviews the value and advances in ITP-related biomarkers.

Diagnostic and therapeutic value of endoscopic retrograde appendicitis therapy for atypical acute appendicitis / 中华消化内镜杂志

Objective To investigate the value of endoscopic retrograde appendicitis therapy ( ERAT) in the diagnosis and treatment of atypical acute appendicitis. Methods All the 48 patients suspected of atypical acute appendicitis in Jiangsu Province Hospital from January 2015 to December 2016 were randomly divided into ERAT group and conservative treatment group according to the treatment method. The final appendectomy rate of the two groups was analyzed. Results Only 17 of the 24 patients in the ERAT group received endoscopic treatment because of complex conditions or personal wishes, and 16 cases were diagnosed as acute appendicitis. Surgical resection was performed in 5 cases because of recurrence of the disease after ERAT, and the appendectomy rate was 31. 2％ ( 5/16 ) . In the conservative treatment group, all 24 patients were treated with antibiotics. Twenty of them underwent surgical resection with appendectomy rate of 83. 3％ ( 20/24) , and 1 of them had appendiceal perforation. The appendectomy rate of the ERAT group was significantly lower than that of the conservative treatment group (χ2=11. 111, P<0. 05) . Conclusion ERAT has a high diagnostic and therapeutic value for atypical acute appendicitis.

Microsurgical treatment of large acoustic neuromas / 中华显微外科杂志

Objective To explore the skill of mien)surgical removal and preservation and functional recovery of facial nerve for large acoustic neuromas.Methods The clinical data of 82 consecutive patients with large acoustic neuromas operated upon through the suboccipital retrosigmoid approach were retrospectively reviewed.The cases with HB grade Ⅲ - Ⅵ of facial nerve were divided randomly into two groups,the one group was given conventional therapy and the other group was given Kabato rehabilitation training.Results In those cases,acoustic neuromas were totally removed in 77 (93.9%),subtotally removed in 5.Facial nerve was kept anatomically intact in 78 cases of the patients (95.1%).Recovery of facial nerve function was faster and more effective in the training group than that in the un-training group.During the follow-up ranging from 6 months to 3 years,among 5 cases of subtotally resection,2 cases relapsed.Three patients in our series complained of chronic headache postoperatively.No patient long time coma or died.Conclusion The goal of large acoustic neuromas treatment should be total removal in one stage and preservation of facial nerve function,as they determine a patient's quality of life.Kabat rehabilitation training is the effective method of functional recovery of facial nerve after operation.

Construction and evaluation of intracerebral capsular hemorrhage models in rats / 中国组织工程研究

BACKGROUND: A stable and exact animal model is the necessary tool and basis for studying hemorrhagic cerebrovascular diseases.OBJECTIVE: To establish and evaluate the intracerebral capsular hemorrhage models in rats.DESIGN: A randomized and controlled animal experiment.SETTING: Second Hospital Affiliated to Xuzhou Medical College; First Hospital Affiliated to Nanjing Medical University.MATERIALS: This experiment was carried out in the animal experimental center of Nanjing Medical University during May to November 2002.Totally 35 SD rats were randomized into two groups: experimental group (n=30) and sham-operation group (n=5).METHODS: ① Autoblood was injected into the intracerebral capsule of rats to create intracerebral capsule hemorrhage models with stereotaxy in the experiment group. ②Scoring was conducted according to 5-point neurological scoring criteria from ZeaLonga, somatic sensation and motor function of rats were observed. ③Somatosensory evoked potential(SEP) of rats was detected pre- and post-operation under anesthetic state. ④ After determination of SEP, the rats were sacrificed under anesthetic state. Brains were taken out to made slices, then sections were stained with haematoxylin and eosin. Changes in haematoma and histomorphology were observed at the largest focus under optical microscope.MAIN OUTCOME MEASURES: ①Nerve function scoring; ②Latent period of various waves of SEP; ③ Observation of brain tissue morphology.RESULTS: Totally 35 rats entered the stage of result analysis. ①Appearance of obvious paralysis of the rats suggested the modeling was successful. The successful rate of this experiment was 93.3%(28/30). Significant difference existed in neurological scoring between experimental group [(2.74±0.46)points] and sham-operation group (0 point)(P＜0.05). ②SEP showed that the latent periods of various waves of experimental group after operation were significantly delayed than those before operation and those of sham-operation group [P1: (15.72±0.78) ms, (10.69±0.52) ms, (10.73±0.48) ms;Nl: (17.95±1.27) ms,(13.21±1.31) ms, (13.34±1.27) ms;N2:(21.16±1.62) ms, (15.42±1.46) ms,(15.58±1.44) ms;N3:(24.86±1.58) ms, (18.72±1.76) ms, (18.99±1.67) ms,P＜0.05]. ③In the shamoperation group, a few red blood cells were scattered in the peripheral area of needle channel were found, but hemorrhagic focus was not; In the experimental group, irregular or oval blood clots presented in the left internal capsule area. In about a low-fold visual field, brain tissue in the surrounding of hemorrhagic focus was loosened and swelled, and pathological changes were obviously severer than those in the sham-operation group.CONCLUSION: Intracerebral capsular hemorrhage induced by injection of autoblood with stereotaxy is more close to clinical situation, and it is easy to operate and has good reproducibility.

Facial nerve preservation in acoustic neuroma microsurgery / 中华显微外科杂志

Objective To study the skills of facial nerve preservation in acoustic neuroma microsurgery. Methods Seventy four cases of acoustic neuromas treated microsurgically by suboccipital retrosigmoid transmeatus approach were analyzed retrospectively, including their clinical symptoms and characteristic image, the pathological anatomic relationships of facial nerve and tumor, microsurgical technique. Results Total resection of the tumor was achieved microsurgically in 72 cases, subtotal resection in 2 cases. Facial nerve was kept anatomic intact in 67(90.5%) of the patients. Intracranial end to end anastomosis of the facial nerve was performed in 4 cases. No patient died in this series. Conclusions Microneurosurgical technique is a safe and effective method for total resection of acoustic neuroma. It is key point for keeping facial nerve anatomic intact to understand the pathological anatomic relationships of facial nerve and tumor.

Transorbitozygomatic microsurgery for cavernous sinus tumors / 中华显微外科杂志

Objective To explore the microsurgical skills and clinical value of transorbitozygomatic approach for cavernous sinus tumors. Methods A retrospective research was given to 19 patients with cavernous sinus tumors microsurgically treated by transorbitozygomatic approach.Their tumors pathological types,clinic symptoms,characteristic images,surgical approach,surgical skills and postoperative complications were systemically analyzed. Results Total removal of the tumor was achieved in 17 cases and subtotal removal in 2 cases.38 percent of cranial nerves deficit was improved,43 percent of cranial nerves symptoms did not change,and 19 percent of cranial nerves palsies worsened.New cranial nerves symptoms occurred in 5 cases.No other severe complications or death occurred in all cases. Conclusion Transorbitozygomatic approach can preferably expose and totally resect cavernous sinus tumors.Knowing macro-micro anatomy of this approach,understanding the pathological-anatomic relationships betweem tumor and cavernous sinus,having practiced microsurgical skills are the linchpins to resect the tumor totally and protect cranial nerves effectivctively.

Microsurgical treatment of petroclival tumors by transpetrosal presigmoid approach / 中华显微外科杂志

Objective To explore clinical curative effect of microsurgery of petroclival tumors by transpetrosal presigmoid approach. Methods A series of 23 patients of petroclival tumors resected by microneurosurgery were analyzed retrospectively, including tumors histological types, clinical and preoperative MRI features, operative approaches, surgical technique and common postoperative complications. Results Total resection of the tumor was achieved microsurgically in 16 cases, subtotal resection in 4 cases, partial resection in 3 cases. No patient died in this series. 8 patients presented worsening crainal nerves palsies postoperatively. CSF leaks were uncommon, occuring in 2 patients. Conclusion The tumors in petroclival region can be totally resected by transpetrosal presigmoid approach. The advantages were offered by this approach such as the temporal lobes and cerebellum are minimally retracted; the operative distance of petroclival tumors is shortened with exposure of clivus and juxta-clival region.