RESUMO
Objective To analyze the prevalence of and risk factors for infections in patients with pemphigus,and to evaluate their effect on prognosis.Methods Clinical data were collected from 182 inpatients with pemphigus in Department of Dermatology,Xijing Hospital,Fourth Military Medical University from May 2011 to May 2017,and retrospectively analyzed.Associations of infection rates with age,disease severity,comorbidities,maximum dose of glucocorticoids,hospitalization duration and costs were analyzed.Statistical analysis was carried out with SPSS 22.0 software by using Logistic regression analysis for analyzing risk factors for concurrent infections in pemphigus patients who were hospitalized for the first time.Results Among the 182 patients,82 (45.05％) experienced infections.Additionally,107 pathogenic strains were cultured from secretions from skin lesions of 77 patients,including 60 strains of Staphylococcus aureus (56.07％),and 58 Staphylococcus aureus strains were resistant to penicillin (96.67％).Among the 182 patients,infections were observed in 11 of 14 patients with hypoproteinemia,69 (41.07％) of 168 patients without hypoproteinemia,4 (4.81％) of 27 patients with mild pemphigus,34 (37.7％) of 90 patients with moderate pemphigus and 44 (67.69％)of 65 patients with severe pemphigus.Logistic regression analysis showed that the prevalence rate of infections was significantly higher in the patients with hypoproteinemia than in those without hypoproteinemia (OR =5.559,95％ CI 1.053-29.347,P =0.043).Compared with the patients with mild pemphigus,the prevalence rate of infections significantly increased in the patients with moderate (OR =4.676,95％ CI 1.276-17.123,P ＜ 0.05) or severe pemphigus (OR =16.529,95％ CI 4.183-65.314,P ＜ 0.001).The prevalence of infections in patients with pemphigus was unaffected by gender,types of pemphigus,or the presence of hypertension or diabetes (all P ＞ 0.05).Among the 145 patients who were followed up,33 were completely cured,67 were cured clinically,23 received improvement,10 experienced relapse or exacerbation,and 12 died.Of the 12 dead patients,3 died of pneumonia,2 died of exacerbated pemphigus and skin infections,and 1 died of sepsis.Conclusions High disease severity and hypoproteinemia are risk factors for infections in patients with pemphigus.Bacterial infection is a common complication in patients with pemphigus,and severe infections are one of the causes of death in patients with pemphigus.
RESUMO
Objective:To investigate the clinical outcomes of arthroscopic adhesiolysis on patients with primary frozen shoulder and its effect on shoulder joint function.Methods:The clinical data of 54 patients with primary frozen shoulder who visited Civil Aviation General Hospital from March 2017 to July 2018 were retrospectively analyzed. According to different treatment regimens, the patients were divided into a study group and a control group, with 27 patients in each group, there were 11 males and 43 females, aged (47.6±3.4) years, and the age ranged from 41 to 64 years. Patients in the control group were treated with conventional conservative treatment measures, and patients in the study group were treated with loose adhesion under arthroscope on the basis of the control group. The shoulder joint activity (range of motion angles for flexion, abduction and lateral rotation), Constant score, UCLA score and VAS score as well as the complications of the two groups were compared. The measurement data were expressed as mean±standard deviation ( Mean± SD), the t test was used for comparison between groups. The count data were expressed as percentage and the chi-square test was used for comparison between groups. Results:In the study group, postoperative anterior flexion, abduction, lateral external rotation were (160.2±20.7)°, (163.6±20.1)°, (50.5±8.9)°, respectively. The patients in the control group experienced (119.5±19.5)° of anterior flexion, (121.2±19.5)° of abduction, (35.6±6.4)° of lateral external rotation. After treatment, the activity of the shoulder joint in the study group was significantly better than that in the control group, there were statistically significant differences between the two groups( P<0.05). In the study group, the postoperative Constant score was (83.1± 9.3) scores, VAS score was (2.8±0.3) scores, UCLA score was (31.7±3.1) scores; in the control group, the postoperative Constant score was (71.7±9.7) scores, VAS score was (4.4±0.3) scores, UCLA score was (22.8±3.6) scores ( P<0.05). Compared with the control group, the Constant score and UCLA score in the study group were significantly higher, and the VAS score was significantly lower, differences were statistically significant( P<0.05). The difference in the incidence of complications between the two groups was not statistically significant ( P>0.05). Conclusions:For patients with primary frozen shoulder, arthroscopic adhesiolysis can significantly improve the shoulder function of patients. At the same time, this operation has significant clinical treatment effect, which is conducive to the clinical application and promotion.
RESUMO
Objective@#To analyze the prevalence of and risk factors for infections in patients with pemphigus, and to evaluate their effect on prognosis.@*Methods@#Clinical data were collected from 182 inpatients with pemphigus in Department of Dermatology, Xijing Hospital, Fourth Military Medical University from May 2011 to May 2017, and retrospectively analyzed. Associations of infection rates with age, disease severity, comorbidities, maximum dose of glucocorticoids, hospitalization duration and costs were analyzed. Statistical analysis was carried out with SPSS 22.0 software by using Logistic regression analysis for analyzing risk factors for concurrent infections in pemphigus patients who were hospitalized for the first time.@*Results@#Among the 182 patients, 82 (45.05%) experienced infections. Additionally, 107 pathogenic strains were cultured from secretions from skin lesions of 77 patients, including 60 strains of Staphylococcus aureus (56.07%) , and 58 Staphylococcus aureus strains were resistant to penicillin (96.67%) . Among the 182 patients, infections were observed in 11 of 14 patients with hypoproteinemia, 69 (41.07%) of 168 patients without hypoproteinemia, 4 (4.81%) of 27 patients with mild pemphigus, 34 (37.7%) of 90 patients with moderate pemphigus and 44 (67.69%) of 65 patients with severe pemphigus. Logistic regression analysis showed that the prevalence rate of infections was significantly higher in the patients with hypoproteinemia than in those without hypoproteinemia (OR = 5.559, 95% CI 1.053-29.347, P = 0.043) . Compared with the patients with mild pemphigus, the prevalence rate of infections significantly increased in the patients with moderate (OR = 4.676, 95% CI 1.276-17.123, P < 0.05) or severe pemphigus (OR = 16.529, 95% CI 4.183-65.314, P < 0.001) . The prevalence of infections in patients with pemphigus was unaffected by gender, types of pemphigus, or the presence of hypertension or diabetes (all P > 0.05) . Among the 145 patients who were followed up, 33 were completely cured, 67 were cured clinically, 23 received improvement, 10 experienced relapse or exacerbation, and 12 died. Of the 12 dead patients, 3 died of pneumonia, 2 died of exacerbated pemphigus and skin infections, and 1 died of sepsis.@*Conclusions@#High disease severity and hypoproteinemia are risk factors for infections in patients with pemphigus. Bacterial infection is a common complication in patients with pemphigus, and severe infections are one of the causes of death in patients with pemphigus.
RESUMO
At present,specific targeted treatment of vitiligo is still lacking,and there are many limitations of current therapies,such as slow repigmentation process,long duration of treatment and frequent recurrence.As a therapeutic strategy for rapidly improving the appearance of patients,camouflage therapy has a unique advantage in the treatment of various skin diseases.Several studies in China and other countries have shown that the correct use of cosmetic camouflage can effectively improve the appearance and quality of life of patients with vitiligo.This review summarizes the knowledge about various camouflage therapies and related clinical researches on the relationship between camouflage therapies and quality of life of patients with vitiligo,and elaborates application prospects of camouflage therapies in the treatment of vitiligo.
RESUMO
ObjectiveTo detect the expression level of programmed cell death (PDCD) 5 and tumor necrosis factor(TNF)-α in serum and joint fluid from rheumatoid arthritis (RA) and osteoarthritis (OA)patients,and analyze the correlation between PDCD5 and TNF-α in order to study the role of PDCD5 in the pathogenesis of RA.MethodsFiftypatients(including 26 RA,24 OA) between December 2009 and August 2010 were selected to this study.ELISA was used to detect the concentration of PDCD5 and TNF-α in the serum and joint fluid.Two-independent sample t-test and Pearson's correlation analysis were used for statistics.ResultsIn both serum and joint fluid,the concentration of PDCD5 from RA patients [(37±33) vs (37±26) pg/ml ] was significantly higher than that of OA patients [ ( 13± 14) vs ( 11 ±7 ) pg/ml ] (P＜0.05).The concentration of TNF-α in the serum from RA and OA patients did not differ significantly(P=0.122),but its concentration in joint fluid of RA patients was significantly higher than that of OA patients (P=0.037).In the serum,there was significant correlation between PDCD5 and TNF-α (r=-0.55,P=0.004; r=-0.51,P=0.012)in both RA and OA patients.The correlation between PDCD5 and TNF-α in joint fluid of RA patients was statistically significant(r=-0.49,P=0.012),but no correlation could be found in joint fluid between PDCD5and TNF-α of OA patients(r=-0.353,P=0.09).ConclusionThis study suggests that PDCD5 and TNF-αare important apoptosis-regulatory factors in RA,and play important roles in the occurrence and development of RA.
RESUMO
Objective To test the hypothesis that p53 gene therapy combined with endostatin can enhance tumor response to radiation therapy of RM-1 mouse xenograft prostate cancer and to investigate its mechanism. Methods A mouse prostate cancer model was established. Then mice with xenograft tumor were randomly divided into group A (control), B (radiation), C (radiation and rAdp53), D (radiation and rh-endostatin) and E (radiation and rAdp53 and rh-endostatin). On day 1, rAdp53 was injected intra-tumorously with 1 × 1010 vp per animal to group C and E. From day 1 to 14, rh-endostatin was given 15 mg/kg intraperitoneally daily to group D and E. On day 4 single fraction of 15 Gy was given to tumors in groups B, C, D and E. Normal saline was injected intra-tumorously or intraperitoneaUy accordingly as control. No treatment was done to group A. Tumor volume was measured daily. Samples were collected on Days 5, 10 and 15. Ki67, CD31, p53 and VEGF were detected by means of immunohistochemistry. Results (1) Radiation alone, radiation combined with intra-tumorous injection of Adp53 and/or intraperitoneal injection of rh-endostatin resulted in tumor growth arrest of RM-1 cells in vivo (P = 0.000). Radiation combined with both rAdp53 and rh-endostatin was the most effective treatment (P < 0.05). (2) All the four treatment groups had a decreased expression of mutant type P53 (P = 0.000). The expression of Ki67 in groups B and C were equal (P 0.05) and increasing (P = 0.000), respectively. Group D had a up-down-up curve (P < 0.05), but group E had a up-down one. On day 5 the expresion of VEGF in group E was the lowest (P < 0.05). An increased expression of MVD compared with the control was shown, and MVD in groups C, D and E were always higher than that in the control (P < 0.05). Conclusions The limitation of radiotherapy could be overcome by combination with beth p53 gene therapy and endostatin on the growth of mouse prostate cancer cell. Radiation, rAdp53 and endostatin have their own role but they can be interacted with each other.