Analysis of serum allergen-specific immunoglobulin E in 3 051 patients with eczema or dermatitis in an allergy clinic / 中华皮肤科杂志

Objective:To analyze measurement results of serum allergen-specific immunoglobulin E (IgE) in patients with eczema/dermatitis.Methods:A retrospective analysis was conducted on serum allergen-specific immunoglobulin E (IgE) levels in 3 051 patients with eczema/dermatitis, who visited the allergy clinic of Huashan Hospital from April 1, 2021 to March 31, 2022. The serum allergen-specific IgE level was detected by using the Phadia allergen detection system, and positive rates of allergens were calculated to determine common inhaled allergens and food allergens in patients with eczema/dermatitis. Comparisons of enumeration data between groups were performed by chi-square test.Results:Among the 3 051 patients with eczema/dermatitis, there were 1 412 with atopic dermatitis and 1 639 were other eczema/dermatitis. Detection of serum allergen-specific IgE showed that 1 629 (53%) patients were positive for allergens, and the number of positive allergen-specific IgEs in each patient was 3.0 ± 1.6. The top 3 common inhaled allergens in patients with eczema/dermatitis were Dermatophagoides farinae (904/1 522, 59%) , Dermatophagoides pteronyssinus (891/1 513, 59%) and Alternaria alternata (206/1 068, 19%) , and the top 3 common food allergens were shrimps (251/1 432, 18%) , egg white (165/992, 17%) and cow milk (149/994, 15%) . Among the 3 051 patients, 25 (1%) were aged < 2 years, 571 (19%) aged 2 - 12 years, 285 (9%) aged 12 - 18 years, and 2 170 (71%) were aged > 18 years. The most common food allergens were both egg white in the age groups of < 2 years and 2 -12 years (77%, 37%, respectively) , and were both shrimps in the age groups of 12 - 18 years and > 18 years (31%, 17%, respectively) . Dermatophagoides pteronyssinus and Dermatophagoides farina were the top 2 common inhaled allergens in all age groups, with the positive rate ranging from 36% to 84%; in addition, the positive rate of molds was relatively high in the age group of 2 - 12 years (mold mixture: 37%; Alternaria alternata: 27%) . From April 2021 to March 2022, the positive rate of outdoor allergens ranged from 10% to 15% among outpatients in every month; the positive rates of tree pollen and grass pollen increased from April 2021, and peaked in October 2021. The patients with atopic dermatitis showed a significantly increased positive rate of allergens (73%) compared with those with other eczema/dermatitis (37%, χ2 = 389.36, P<0.001) , and the rank of common allergens in the patients with atopic dermatitis was basically the same as that in those with eczema/dermatitis. Conclusions:The common allergens were Dermatophagoides farina, Dermatophagoides pteronyssinus and Alternaria alternata in the patients with eczema/dermatitis. Food allergy was more common in infant patients, and inhalation allergy was more common in child, adolescent and adult patients. The positive rate of allergen-specific IgEs was markedly higher in the patients with atopic dermatitis than in those with other eczema/dermatitis.

Effect of surgical treatment for anorectal melanoma: a propensity score-matched analysis of the Surveillance, Epidemiology, and End Results programme data.

OBJECTIVE: Anorectal melanoma (AM) is a rare but aggressive tumour with limited information in the existing literature. This study aimed to assess the effect of surgical treatment for AM and predict the prognosis of affected patients. DESIGN: A retrospective cohort study. SETTING: Data of patients diagnosed with AM between 1975 and 2016 in the USA were collected from the Surveillance, Epidemiology, and End Results (SEER) database. PARTICIPANTS: This study enrolled a total of 795 patients with AM from the SEER database and the validation cohort comprised 40 patients with AM enrolled from Chinese institutes. PRIMARY AND SECONDARY OUTCOME MEASURES: Overall survival (OS) and AM-specific survival (AM-SS). RESULTS: A total of 795 patients with AM diagnosed between 1975 and 2016 were enrolled in this study. Data over the past four decades showed a trend of increase in incidence rate. A nomogram based on a multivariate Cox regression model was generated to predict AM-SS. The C-index of the nomogram was 0.74 (95% CI 0.71 to 0.77) on internal verification. In the validation cohort, the C-index of the nomogram was 0.72 (95% CI 0.68 to 0.76). The results of propensity score matching (PSM) analysis showed that patients who underwent surgical treatment achieved significant survival (OS: log-rank=17.41, p<0.001; AM-SS: log-rank=14.55, p<0.001). Patients who underwent surgery were stratified into local and extended surgery subgroups. AM-SS and OS were also compared after PSM, but the results were not significantly different between the two surgery subgroups (all p>0.05). CONCLUSIONS: The nomogram based on the analysis of SEER data showed good performance in predicting OS and AM-SS. Patients with AM can benefit from surgery; however, extensive surgery and appendectomy may not improve AM-SS or OS.

Experimental study and reflection on peacetime and wartime reconstruction of large general hospitals in public health emergencies / 中南大学学报(医学版)

To propose the architectural layout for the big general hospital in the face of public health emergencies, we analyzed the conditions, methods, problems and countermeasures for the reconstruction of the isolation ward from the existing medical building layout of a general hospital. The affected areas met the requirements of isolation ward in the reconstruction, and realized the corresponding partition and separation of people. But the cost of occupying the medical room should be concerned. General hospital should be alerted to potential risks of public health emergencies. The characteristics of different construction types, defects, and the function of the hospital should be considered in the construction, rebuilding, and expansion of the hospital, which shouldnot only meet the needs of the development of the hospital daily usage but also consider dealing with emergent public health events. We can adopt the reasonable layout, including setting up a firewall-like device between the channel and the floor, an ordinary ward at ordinary times, and an independent space for emergency by pulling down the gate. This strategy can not only avoid the problem of low utilization rate of the space occupied by the corresponding area in the ward for diseases spread by air and droplets, maximizing the efficiency of the medical site, but also avoid the problem of emergency response to the temporary reconstruction.

Biological function of protein tyrosine phosphatase H-type receptor and its progress in tumor / 中南大学学报(医学版)

Protein tyrosine phosphatase H-type receptor (PTPRH) gene encodes a gastric cancer associated protein, which exerts its biological function through tyrosine phosphorylation in the post-translational COOH- terminal region. PTPRH is abnormally expressed in a variety of tumors, and its biological function is closely related to the occurrence, development and prognosis of tumors.

Predictive value of a modified classification of fallopian tube status on prognosis of tubal factor infertility after laparoscopic surgery.

Built on 2 existing classification systems, this study was to develop a new classification system to better predict the pregnancy prognosis after laparoscopic surgery in patients with tubal factor infertility and accordingly propose a management strategy.We followed up 423 patients suffering from tubal factor infertility who had undergone hysteroscopic-laparoscopic surgery for 2 years without in vitro fertilization and embryo transfer (IVF/ET). Based on the operative reports, a new, modified classification of fallopian tube status (hereafter referred to as the modified classification) was developed with reference to the 2 existing classification systems (the r-AFS classification of pelvic adhesions and the scoring system of distal tubal obstruction). A score of 0 to 3 was assigned to each of the 4 factors (tubal wall consistency, hydrosalpinx, pelvic adhesions, and tubal patency) for each of the tubes with a total bilateral score of 0 to 24. The patients were classified for the abnormalities of the fallopian tubes into 3 groups: mild (<8), moderate (8-15) and severe (>15). By utilizing SPSS 20.0 Statistic Analysis Software, the data were analyzed with t test, Chi-Square test, ANOVA or ROC as appropriate.Each of the 4 factors of the modified classification was independently and closely associated with post-surgical prognosis (P < .05). There was a statistically significant difference in postoperative pregnancy prognosis among the 3 groups of patients (P < .05). Patients with a score of <8 (mild) had the highest intrauterine pregnancy rate, reaching 60.1%. In contrast, patients with a score of 8 to 15 (moderate) had a significant increase in ectopic pregnancy (21.5%), while patients with a score of >15 (severe) had a significantly increased infertility rate of 89.5%. When the pregnancy outcomes were divided into intrauterine pregnancy and other outcomes, the modified classification had the largest area under the ROC curve (0.569) (P < .05). With the optimum cutoff of 4.5, the sensitivity was 88.6%, specificity was 74.5% and accuracy was 63.1%.The modified classification of fallopian tube status is a simple and practical scoring system which can comprehensively and effectively evaluate the function of the fallopian tube and thus is more accurate than the other 2 systems in predicting the postoperative pregnancy outcomes.

Pedicle screw fixation into the injured vertebra for thoracolumbar fractures：a long-term effect and biomechanical analysis / 中国组织工程研究

BACKGROUND: Pedicle screw fixation is a common repair method for thoracolumbar fractures. Of them, pedicle screw placement into the injured vertebra is an important method. However, the long-term effects and the related biomechanical properties deserve further analysis. OBJECTIVE: To analyze the long-term effect and biomechanical characteristics of the internal fixation of thoracolumbar fractures by pedicle screw implantation. METHODS: A retrospective analysis was performed in 126 cases of thoracolumbar fractures. The patients were treated with pedicle screw implantation and the treatment was fol owed up regularly. Ten specimens of fresh calf chest and lumbar spines were obtained. Five specimens served as an experimental group to prepare models of anterior middle column fractures, and these specimens received pedicle screw fixation into the injured vertebra. The other five specimens served as the control group, and did not receive any treatment. In the two groups, along the sagittal axis, axial compression displacement, anterior flexion displacement, posterior extension displacement, torsion angle and pul -out strength were measured and recorded. RESULTS AND CONCLUSION: (1) Clinical trial results: 126 patients were fol owed up for 10-36 months. Compared with pre-treatment, compression ratio of the injured vertebra, the height of intervertebral space, vertebral slip distance, visual analogue score and Cobb angle were significantly improved at 1 month after treatment and during final fol ow-up (al P 0.05). At the end of fol ow-up, Frankel spinal cord injury grade was significantly improved (Z=-4.127, P 0.05). (3) Above findings showed that pedicle screw fixation into the injured vertebra for thoracolumbar fractures obtained good long-term effects, and had good biomechanical properties.

Surgical treatment and prognosis of left obstructive colorectal carcinoma / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of surgical management and prognosis of left obstructive colorectal carcinoma.@*METHODS@#Clinical data of 109 patients with acute left obstructive colorectal carcinoma treated by emergent operation in Xiangya Hospital from October 2000 to February 2008 were retrospectively analyzed.@*RESULTS@#All the 109 patients received operation. Of them, 66 patients received one stage tumor resection and intestinal anastomosis. Postoperative complication rate was 26.6%(29/109) and mortality rate was 0.9%(1/109). The postoperative 1-, 3-, and 5-year survival rates were 94.4%, 73.3%, and 43.2%, respectively. The 1-,3-,and 5-year survival rates of patients receiving curative resection were 100.0%,93.6%, and 66.7%, respectively. With univariate analysis, radical resection, Dukes stage, tumor differentiation, and chemotherapy were found to be significant factors associating with the overall survival. With multivariate analysis, radical resection independently affected the overall survival.@*CONCLUSION@#One stage radical resection and anastomosis are feasible for left obstructive colorectal carcinoma. Appropriate choice of the operative procedure, skillful operative techniques, and prudential peri-operative treatment can enhance the curative effect and patients quality of life.

Expression of Transforming Growth Factor-?_1 in Colorectal Adenocarcinoma / 中国医师杂志

Objective To investigate the relationship between the expression of transforming growth factor-? 1(TGF-? 1) and the differentiation and metastasis of colorectal adenocarcinoma. Methods The expression of transforming growth factor-? 1 in 42 samples of colorectal adenocarcinoma was observed with immunohistochemical technique. Results ⑴The levels of TGF-? 1 expression were significantly higher in poorly differentiated adenocarcinoma than that in high differentiated cancer (P

Surgical management of obstructive colorectal carcinoma / 中国普通外科杂志

Objective To exprole the effect of surgical management of obstructive colorectal carcinoma. Methods A restrospective analysis was made on the clinical data of 76 cases of acute obstructive colorectal carcinoma treated by emergent operation in Xiangya Hospital from October 1997 to October 2002.Among the 76 cases,there were 23 cases of right colon obstruction and 53 cases of left colon or rectal obstruction. Results All the 76 patients received opreation , 55 patients received one stage tumor resection and large intestinal anastomosis, including 19 in right colon and 36 in left colon or rectal obstruetion.Postoperative complications rate was 15.7%(11/76) in this series,including anastomotic leakage in 2, disruption of wound in 1, infection of incisional wound in 6, and pneumonia in 2.Expect one patient died of MSOF,the others were curred by non-operation therapy.The postoperative 1,3,5year survival rate was 98.3%,55%,38.5% in this series.Conclusions One stage resection and anastomosis is a feasible operation for obstructive colorectal carcinoma.Appropriate choice of the operative procedure, skillful operative technique,and prudential perioperative treatment can enhance the cuerative effect and the patients quality of life.

Evaluation of Carcinoembryonic Antigen (CEA) and Carbohydrate199 (CA199) Determination in Recurrence After Radical Colonic Cancer Surgery / 中国医师杂志

Objective To study the clinical values of CEA,CA199 in predicting recurrence of colonic cancer.Methods Radioimmunoassay (RIA) was used to measure serum CEA and CA199 in 60 colonic cancer recurrence patients and 60 non-gastrointestinal patients.Results The serum CEA and CA199 levels in colonic cancer group were significantly higher than those in control group (P

Digestive tract reconstruction after total gastrectomy for gastric cancer / 中国普通外科杂志

Objective To study the optimal procedure of digestive tract reconstruction after total gastrectomy.Methods The clinical data of 122 patients who underwent total gastrectomy in the recent 6 years were(analyzed) retrospectively.Three types of reconstruction procedures,including Orr-type Roux-en-Y(esophagojejunostomy),P-type jejunal pouch Roux-en-Y esophagojejunostomy and distal jejunal aboral pouch Roux-en-Y esophagojejunostomy,were performed.Results There were no significant differences among the three procedures in heartburn and the amount of food intake,frequencies of meal,weight loss,dumping(syndrome),and hemoglobin and albumin levels.The operation time in P-type group was longer than the other two group(P

Ano-saving surgery in lower rectal carcinoma: a report of 320 cases / 中国普通外科杂志

Objective To evaluate the indication,operation pattern and therapeutic effect of ano-saving surgery for lower rectal carcinoma. Methods Retrospective analysis on the clinical feature of 320 patients with lower rectal carcinoma (postoperative time ≥5 years)treated by ano-saving surgery, the 5-year survival rate, local recurrence rate, and mortality were compared in the various operations. Results The success performed rate of ano-saving operation for lower rectal cancer was 58.5%(320/547).Among them, anastomotic leakage after surgery occurred in 4 cases (1.25%), and 26 cases had anastomostic narrowness (8.13%) within 1 year after surgery.The defecation function after surgery, in patients received colonic J pouch or transverse coloplasty pouch was much better than that in patients received coloanal or colorectal anastomosis. 5-year survival rates, and anastomostic recurrence rates were as follows:In ultra-low anastomosis were 63.24% and 10.27%. Park′s operation 66.67% and 5.13%, local resection 89.46% and 10.71%, respectively. 5-year recurrence rate in the pelvic soft tissue was 3.44%(11/320).Two cases died after operation. Conclusions Lower or ultra-low colon-rectum anastomosis becomes the main operative pattern in preserving anal sphincter in lower rectal cancer.Local resection of lower rectal tumor might be considered if the indecation is selected strictly. Colonic-J-pouch or transverse coloplasty pouch is good for improving the defecation function after ano-saving surgery for lower rectal cancer.

Treatment of severe acute pancreatitis: a review of 217 cases / 中国普通外科杂志

Objective To investigate the principles of treatment for severe acute pancreatitis(SAP). Methods A retrospective analysis of the data of 217 cases of SAP with regards to clinical features,mortality rate and conversion to surgical operation.In this group,66 cases received early operation and 24 cases were converted to operation after initial conservative treatment.Results The overall cure rate was 80.2%(174/217). Among them,90 cases underwent operative treatment,with a cure rate of 72.2%(65/90),and 127 cases underwent conservative treatment with a cure rate of 85.8%(109/127).Conclusions The initial treatment of SAP should be conservative. Operation should be performed if there is a specific indication for early surgical intervention,or for conversion to operation.

Diagnosis and treatment of gastric volvulus: a report of 30 cases / 中国普通外科杂志

Objective To investigate the pathogenesis, diagnosis and treatment of gastric volvulus. Methods The clinical data of 30 patients with gastric volvulus were analyzed retrospectively. Results 17 patients(56.7%) were diagnosed preoperatively,and 13 patients(43.3%) at exploratory laparotomy. 21 cases(70.0%) was diagnosed as organo-axial type, 8 cases(26.7%) as mesenterico-axial type, and 1 case((3.3%)) as combined type.3 patients underwent gastric volvulus restoration by endoscopy;27 patients (received) operation,and all the 30 patients were discharged in good health.All of the cases were followed up for 5 years;one case,treated by endoscopy,recurred,but none of the other cases recurred. Conclusions Laxity of gastric suspensory ligaments is the main pathogenetic factor of gastric volvulus,but its occurrence is usually caused by multiple factors.The diagnosis depends on the combined analysis of the clinical (manifestations) and radiographic studies or exploratory laparotomy. Operation is the first choice of treatment.