Bencycloquidium bromide nasal spray is effective and safe for persistent allergic rhinitis: a phase III, multicenter, randomized, double-blinded, placebo-controlled clinical trial.

PURPOSE: To investigate the efficacy and safety of bencycloquidium bromide nasal spray (BCQB) in patients with persistent allergic rhinitis (PAR). METHODS: We enrolled 720 patients from 15 hospitals across China and randomly assigned them into BCQB group or placebo group (90 µg per nostril qid) to receive a 4-week treatment. Visual analog scale (VAS) for rhinorrhea, sneezing, nasal congestion, itching and overall symptoms were recorded by patients every day. Anterior rhinoscopy scoring was completed by doctors on every visit. Adverse events were recorded in detail. RESULTS: A total of 354 and 351 patients were included in BCQB group and in placebo group. Baseline information was comparable. At the end of the trial, the decrease of VAS for rhinorrhea from baseline was 4.83 ± 2.35 and 2.46 ± 2.34 in BCQB group and placebo group, respectively (P < 0.001). The change ratio from baseline of VAS for rhinorrhea in BCQB group was 72.32%, higher than 31.03% in placebo group (P < 0.001). VAS for other symptoms and overall symptoms also improved significantly in the BCQB group, while no inter-group difference was found in anterior rhinoscopy scoring. The incidence of adverse reaction was similar between the two groups. Most reactions were mild and no severe reactions happened. CONCLUSION: 90 µg BCQB per nostril four times daily is effective and safe in the treatment of rhinorrhea as well as sneezing, nasal congestion and itching for patients with PAR. RETROSPECTIVELY REGISTERED: ChiCTR2000030924, 2020/3/17.

[Deep neck infection: clinical analyses of 95 cases].

OBJECTIVE: To review the recent diagnosis and treatment experience with deep neck infection and emphasize the importance of radiologic evaluation, microbiology and appropriate treatment selection in these patients. METHODS: A respective review was conducted in 95 cases who were diagnosed as having deep neck from Jan. 2006 to March 2015. RESULTS: The primary diseases in 95 patients with deep neck infection were acute tonsillitis or acute laryngitis (27 cases), infection of upper respiratory tract (23 cases), odontogenic infection or oral inflammation (16 cases), foreign bodies in esophagus (9 cases), acute cervical lymphadenitis (5 cases) and cause uncertain (15 cases). Computed tomography was performed in all of patients to identify the location, extent, and character (cellulitis in 47 cases or abscesses in 48 cases) of the infections. The locations of abscess were parapharyngeal abscess (25 cases), retropharyngeal abscess (9 cases), submaxillary space abscess (6 cases), pretracheal space abscess (5 cases) and esophageal abscess (3 cases). COMPLICATIONS: mediastinitis (2 cases), pericarditis (1 case), bilateral pneumothorax (2 cases), and upper digestive tract (1 case). Bacterial cultivation performed in 35 patients and positive results were detected in 21. All patients were given intravenous antibiotic therapy. Tracheotomy was performed in 4 cases. Preoperative contrast enhanced CT was performed in 42 patients and indicated the formation of abscess. Three cases with the symptoms of septic shock were transferred to ICU and one was cured. All the patients were cured except two who died of massive hemorrhage of upper digestive tract and septic shock. CONCLUSIONS: The airway patency in patients with deep neck infections must be ensured. Drainage may be mandatory in selected cases at presentation or in cases who fail to respond to parenteral antibiotics within the first 24-48 hours. Imaging evaluation plays a significant role in the diagnosis and rational therapeutic management in deep neck infection. Bacterial cultivation can help to make the effective treatment and provide reliable evidence for the etiopathogenisis.

The Clinical Evaluation of Perioperative Integrated Operation Approaches in Operation Treatment of Pernicious Placenta Previa / 昆明医科大学学报

Objective To investigate the clinical effect of perioperative integrated operation approaches on the operation treatment of pernicious placenta previa.Methods 50 patients with pernicious placenta were divided into the treatment group (29 cases) and the control group (21 cases).Patients in treatment group were treated by integrated operation approaches,namely before cesarean section,patients were treated by uterine artery catheterization and after the baby was delivered,interventional therapy was applied immediately;patients in the control group were treated by routine operation method.The amount 24 h bleeding,hospital stay,hysterectomy rate and neonatal asphyxia rate were compared in the two groups.Results Compared with the control group,operative time,bleeding volume,bleeding volume in 24 h,postoperative hospitalization time in treatment group were shortened obviously,hysterectomy rate was lower significantly (P＜0.05);the neonatal asphyxia rate difference between the two groups had no statistical significance (P＞0.05).Conclusion Integrated operation approaches can shorten the operation time,bleeding and reduce the hysterectomy rate for patients with pernicious placenta previa,which can maintain the physical and mental health as much as possible,so it is a safe and effective treatment and worthy of clinical promotion.

[Clinal analysis of 202 nasal bone fractures cases].

OBJECTIVE: To evaluate the age, sex, etiology, diagnosis and treatment time of nasal bone fractures. METHOD: Clinical data of 202 cases with nasal bone fractures treated in the hospital were retrospectively analysed. RESULT: A total of 202 cases,163 men (80. 7%) and 39 women (19. 3%). Fifty-two patients had a relationship with alcohol consumption, and all of them were males. The most frequent reasons of the injury were fight 46. 5% (94 cases) followed by falling-down 21. 3% (43 cases), traffic accidents 19. 3% (39 cases), works related 6. 5% (13 cases), sport injuries 5. 9% (12 cases) and others 0. 5% (1 cases). Patients distribution in seasons were: spring 54 cases (26.7%), summer 42 cases (20.8%), autumn 58 cases (28.7%), winter 48 cases (23. 8%). Diagnosis of nasal bone fractures were made positively by x-ray films in 79. 7% of cases, but 100% by CT. Positive predictive value of CT was superior to that of X-ray films in the diagnosis of nasal bone fracture. CONCLUSION: High morbidity of nasal bone fracture was seen in the age group of 20-29 years, and predominantly in male. Fight was found to be the main etiologic factor. We think that CT is necessary for diagnosing nasal bone fracture.

Anatomic study and application of TRAM flap with partial preservation of abdominal rectus muscle in the breast reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and effectiveness of transverse rectus abdominis musculocutaneous (TRAM) flap with partial preservation of abdominal rectus muscle based on the anatomic study in cadavers.</p><p><b>METHODS</b>5 adult female cadavers which provided by department of anatomy of Fujian Medical University were dissected after injection with medical red latex from the starting point of the inferior epigastric artery and superior epigastric artery. The TRAM flap with partial preservation of lateral abdominal rectus muscle were dissected for breast reconstruction. The location, route, branches and anastomosis of inferior and superior epigastric arteries were observed. Based on the anatomic study, breast reconstruction were performed in 8 cases with muscle-sparing TRAM flaps.</p><p><b>RESULTS</b>The inferior epigastric artery arises from external iliac artery (9/10, 90%) or femoral artery (1/10, 10%) at the joint point between the internal third and lateral two third. There are extensive anastomoses between superior and inferior epigastric arteries above the umbilicus, mostly between the 2cm below the first tendinous intersection and umbilical level. From Sept. 2009 to Sept. 2010, 8 cases received breast reconstruction with muscle-sparing TRAM flap. The patients were followed up for 3 months to one year. Fibrosis happened in subcutaneous fat at flap IV zone in 2 cases, borderline necrosis and subcutaneous fat liquefaction occurred in some areas of flap IV zone in 2 cases, which healed after debridement. The other 4 cases healed with no complication. Except for unsatisfied shape in one case, good result achieved in 7 cases. There was no abdominal weakness, hemia or other complication.</p><p><b>CONCLUSIONS</b>It is an effective and safe method in breast reconstruction with muscle-sparing TRAM flap. It is practical with comparatively short operation time and less morbidity in donor site.</p>

Auricular reconstruction for concha-type microtia / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the method of auricular reconstruction for concha-type microtia.</p><p><b>METHODS</b>Two-staged auricular reconstruction was applied in 13 cases (14 ears) with concha-type microtia. The cartilage auricular framework was fabricated and implanted in the first stage, followed by ear elevation and cranio-auricle angle formation at the second stage.</p><p><b>RESULTS</b>The patients were followed up for 2 months to 2 years with satisfactory aesthetic result. The reconstructed ears had a good appearance and position, and were symmetric to the healthy ears.</p><p><b>CONCLUSIONS</b>The two-staged auricular reconstruction with autologous cartilage framework is ideal for concha-type microtia.</p>

Construction of recombinant lentiviral vector of Tie2-RNAi and its influence on malignant melanoma cells in vitro / 中华整形外科杂志

<p><b>OBJECTIVE</b>To construct lentivector carrying Tie2-Small interfering RNA (SiRNA), so as to study its influence on malignant melanoma cells.</p><p><b>METHODS</b>Recombinant plasmid pSilencer 1.0-U6-Tie2-siRNA and plasmid pNL-EGFP were digested with XbaI, ligated a target lentiviral transfer plasmid of pNL-EGFP-U6-Tie2-I or pNL-EGFP-U6-Tie2-II, and then the electrophoresis clones was sequenced. Plasmids of pNL-EGFP-U6-Tie2-I and pNL-EGFP-U6-Tie2-II were constructed and combined with pVSVG and pHelper, respectively, to constitute lentiviral vector system of three plasmids. The Lentiviral vector system was transfected into 293T cell to produce pNL-EGFP-U6-Tie2- I and pNL-EGFP-U6-Tie2-II lentivirus. Then the supernatant was collected to determine the titer. Malignant melanoma cells were infected by both lentiviruses and identified by Realtime RT-PCR to assess inhibitory efficiency.</p><p><b>RESULTS</b>The recombinant lentiviral vectors of Tie2-RNAi were constructed successfully which were analyzed with restriction enzyme digestion and identified by sequencing. And the titer of lentiviral vector was 8.8 x 10(3)/ml, which was determined by 293T cell. The results of Realtime RT-PCR demonstrated that the lentiviral vectors of Tie2-RNAi could infect malignant melanoma cells and inhibit the expression of Tie2 genes in malignant melanoma cells (P<0.01). There was no significant difference in the expression level (P>0.05) between the two lentiviral vectors of Tie2-RNAi.</p><p><b>CONCLUSIONS</b>Lentivector carrying Tie2-SiRNA can be constructed successfully and inhibit the expression of Tie2 gene in vitro significantly. The study will supply the theory basis for the further research on the inhibition of tumor growth in vivo.</p>

Experimental study of repairing skull defect with autogenous cranial bone dust / 中华整形外科杂志

<p><b>OBJECTIVE</b>To build animal model of skull defect for the basic research of skull defects reconstruction with autogenous cranial bone dust and its relevance to the clinical application.</p><p><b>METHODS</b>Three full-thickness parietal skull defects (A, B and C) were created in 30 New Zealand white rabbits. The size of all the defects was 1 cm in diameter. The defect A was left untreated as control. Defects B and C were reconstructed with autogenous cranial bone dust. Two pieces of pyroxylin membrane were placed on the top and bottom of the defect B. every 10 rabbits were killed for analysis at 4, 8, 12 weeks after operation.</p><p><b>RESULTS</b>Defect A was largely repaired with connective tissue. Defect B was repaired rapidly with newly formed cancellous bone in the early period, but the following process of the growth, remodeling and maturing of the newly-formed cancellous bone was slowly. The bone ingrowth in defect C was more mature, but could not repair the defect completely, especially in the central zone. The grafted bone dust was absorbed gradually. Active angiogenesis could be observed in the newly formed bone. For the same defect, new bone had a greater amount of calcium at 12 weeks than at 4 and 8 weeks after operation (P < 0.05). And the calcium content of new bone was higher in defect C than in defect B at 8, 12 weeks after operation (P < 0.05).</p><p><b>CONCLUSIONS</b>The osteogenesis and angiogenesis are closely related to the time and location. The pyroxylin membrane can significantly promote the formation of cancellous bone in defect with autogenous bone dust graft during the early period.</p>

[Clinicopathologic analysis of dilated heart in cardiac transplant recipients].

OBJECTIVE: To study the pathologic features of dilated heart in cardiac transplant recipients, with clinicoradiologic correlation. METHODS: Sixty recipient hearts from cardiac transplantation performed in Fuwai Hospital were analyzed by gross examination, histologic observation and electron microscopy. Clinicoradiologic correlation was available in 40 cases. RESULTS: Amongst the 40 cases of dilated heart, 52.5% (21/40) were due to dilated cardiomyopathy, 22.5% (9/40) due to arrhythmogenic right ventricular cardiomyopathy, 15.0% (6/40) due to ischemic cardiomyopathy, and the remaining 10.0% (4/40) due to miscellaneous causes, including local noncompaction of ventricular myocardium, giant cell myocarditis, alcoholic cardiomyopathy and hypertensive cardiomyopathy. The discrepancy rate between clinical and pathologic diagnosis was 37.5% (15/40). The erroneous categories included arrhythmogenic right ventricular cardiomyopathy (7 cases), ischemic cardiomyopathy (5 cases), and giant cell myocarditis (1 case), which were all mistaken clinically as dilated cardiomyopathy. While ischemic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, noncompaction of ventricular myocardium and giant cell myocarditis have distinctive pathologic features, the diagnosis of alcoholic and hypertensive cardiomyopathies required clinicopathologic correlation. Dilated cardiomyopathy due to viral myocarditis was not identified in the cases studied. CONCLUSION: Pathologic examination is essential in analysis of transplant recipient heart and helps to rectify clinical diagnostic discrepancy.

Clinicopathologic analysis of dilated heart in cardiac transplant recipients / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the pathologic features of dilated heart in cardiac transplant recipients, with clinicoradiologic correlation.</p><p><b>METHODS</b>Sixty recipient hearts from cardiac transplantation performed in Fuwai Hospital were analyzed by gross examination, histologic observation and electron microscopy. Clinicoradiologic correlation was available in 40 cases.</p><p><b>RESULTS</b>Amongst the 40 cases of dilated heart, 52.5% (21/40) were due to dilated cardiomyopathy, 22.5% (9/40) due to arrhythmogenic right ventricular cardiomyopathy, 15.0% (6/40) due to ischemic cardiomyopathy, and the remaining 10.0% (4/40) due to miscellaneous causes, including local noncompaction of ventricular myocardium, giant cell myocarditis, alcoholic cardiomyopathy and hypertensive cardiomyopathy. The discrepancy rate between clinical and pathologic diagnosis was 37.5% (15/40). The erroneous categories included arrhythmogenic right ventricular cardiomyopathy (7 cases), ischemic cardiomyopathy (5 cases), and giant cell myocarditis (1 case), which were all mistaken clinically as dilated cardiomyopathy. While ischemic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, noncompaction of ventricular myocardium and giant cell myocarditis have distinctive pathologic features, the diagnosis of alcoholic and hypertensive cardiomyopathies required clinicopathologic correlation. Dilated cardiomyopathy due to viral myocarditis was not identified in the cases studied.</p><p><b>CONCLUSION</b>Pathologic examination is essential in analysis of transplant recipient heart and helps to rectify clinical diagnostic discrepancy.</p>

Expression and significance of Ang1, Ang2 and receptor Tie2 in hemangioma / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship of angiogenesis and the Ang family members/ receptor (Ang/Tie2) in hemangioma.</p><p><b>METHODS</b>Expression of Ang1, Ang2 and the receptor Tie2 was detected with immunohistochemical SP method and RT-PCR method in 17 cases of proliferating hemangioma, 13 involuting cases and 10 cases of normal children skin.</p><p><b>RESULTS</b>The expression of Ang2 and Tie2 was higher markedly in proliferating hemangiomas than in involuting hemangiomas (P < 0.01), and was rare or negative in normal skin. Expression of Ang1 was rare or negative both in hemangioma and normal skin without significant difference between them (P > 0.05).</p><p><b>CONCLUSION</b>Ang/Tie2 system may play an important role in the proliferating and involuting process of hemangioma.</p>

Estrogen on stimulating the angiogenesis of children's hemangioma in vitro / 中华整形外科杂志

<p><b>OBJECTIVE</b>To demonstrate that estrogen stimulates the angiogenesis of children' s hemangioma.</p><p><b>METHODS</b>A piece of hemangioma biopsy was embedded in fibrin gel, and a model in vitro of angiogenesis of human hemangioma was then established. The angiogenesis of hemangioma in each group was interfered by the estrogen and tamoxifen. There were four groups divided into the followings: the group with estrogen, the group with tamoxifen, the group with estrogen + tamoxifen and the control. The dimension of newborn tubule area in the 3rd, 6th, 9th day after the culture was calculated to compare statistically differences among the groups.</p><p><b>RESULTS</b>In the model of angiogenesis of hemangioma, microvessels grew out from the tissue sample in 2 to 3 days after the culture, and in 8 to 9 days a complex network of microvessels had been shown, the tending to inactivity. On the 3rd,6th and 9th day after the culture the dimension of newborn tubule area of the group of estrogen [(2.84 +/- 0.20) mm2 (12.93 +/- 0.85) mm2 (22.47 +/- 1.40) mm2] were larger than those of the control [(1.98 +/- 0.17) mm2, (7.51 +/- 0.48) mm2, (11.26 +/- 0.73) mm2]. Those of the group of estrogen + tamoxifen [(1.08 +/- 0.11) mm2, (3.54 +/- 0.31) mm2, (5.72 +/- 0.40 mm2] and the group of tamoxifen [(1.13 +/- 0.14) mm2 (4.26 +/- 0.29) mm2, (6.08 +/- 0.42) mm2] were smaller than those of the groups of the estrogen and the control (P < 0.05).</p><p><b>CONCLUSIONS</b>The estrogen may stimulate the angiogenesis of children's hemangioma, and the tamoxifen may reverse the process.</p>

The reconstruction of funnel chest deformity with the reversed transplantation of sternum-costicartilage flap carried by the abdominal rectus pedicle / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the reconstructive operative procedures of funnel chest with "sternum-costicartilage" flap carried by the abdominal rectus pedicle.</p><p><b>METHODS</b>(1) In accordance with the lesioned area of funnel-like depressed deformity of anterior thoracic wall, a perpendicular median incision was designed and made; (2) The "sternum-costicartilage" flap carrying the abdominal rectus pedicle was used and reversed and transplanted to reconstruct severe funnel chest deformity.</p><p><b>RESULTS</b>The procedure was used in 7 cases from 1999 to 2005. The results of surgery were satisfactory. There were no recurrence after operation.</p><p><b>CONCLUSIONS</b>The procedure reported here is rather safe, solid and sound with good therapeutic results, and is of great value in clinical practice.</p>

A three-dimension in vitro model for angiogenesis of hemangioma / 中华整形外科杂志

<p><b>OBJECTIVE</b>To create a three dimension (3D) in vitro model for angiogenesis of hemangioma.</p><p><b>METHOD</b>The fragment of hemangioma specimen was embedded in fibrin gel to set up the three-dimension (3D) in vitro model for angiogenesis of hemangioma.</p><p><b>RESULT</b>In the model, microvessels grew out from the tissue fragments at the 2nd to 3rd day after culture, and at the 8th to 9th day a compact network of microvessels come into being, then tending to be stationary. The compact network around the tissue fragment was confirmed to be blood vessels by immunohistochemistry and electron microscopy.</p><p><b>CONCLUSION</b>This model helps to study the mechanism of hemangioma angiogenesis and investigate the drugs of anti-angiogenesis.</p>

[Clinical-pathological study on 10 cases of pulmonary thromboembolism].

OBJECTIVE: To improve the diagnosis of pulmonary thromboembolism (PTE) by a clinical-pathological analysis of 10 cases of PTE. METHODS: Eight cases of massive and submassive (in the segmental and larger pulmonary arteries) PTE confirmed by autopsy and 2 cases of PTE who underwent surgical treatment in the past 10 years (1991 - 2001) were studied. The specimens were fixed in 10% buffered formalin, and paraffin sections cut, and stained with HE and ET + VG. The pathological features were analyzed. RESULTS: There were 8 males and 2 females, aged 3.5 to 72 years (mean 33.3). The underlining diseases included congenital heart diseases (3 cases of ventricular septal defect complicated with pulmonary hypertension, and 1 case of tetralogy of Fallot), malignant lymphoma in the heart (n = 1), rheumatic heart disease (n = 1), lung metastatic cancer from stomach (n = 1), and phlebitis of the legs (n = 1). The sources of PE remained unknown in 2 cases. Among these cases, only 2 were diagnosed clinically. CONCLUSIONS: The research showed that PTE in patients who had underlining cardiovascular diseases, malignant tumors in the heart or lungs and pneumonia (pulmonary abscess) were hard to diagnose clinically. Pathological study is helpful in improving the clinical diagnosis of PTE.

Expression of apoptosis and Bcl-2, Bax in hemangioma and vascular malformations / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the expression of apoptosis and their regulatory genes, Bcl-2, Bax in hemangioma and vascular malformations.</p><p><b>METHODS</b>The specimens were taken from 68 cases of strawberry hemangioma or vascular malformations and 11 cases of normal skin. The expression of Bcl-2, Bax and Ki-67 in endothelial cells were investigated by immunohistochemical S-P method. The apoptosis index (AI) in endothelial cells was investigated by TUNEL method.</p><p><b>RESULTS</b>Ki-67 was positive in all the proliferating strawberry hemangioma, negative in the other groups. The expression of Bax was significantly higher in strawberry hemangioma than in vascular malformations and normal skin (P < 0.01). Bcl-2 was negative in all groups. The AI in endothelial cells of strawberry hemangioma was significantly higher than that of vascular malformations and normal skin. There were no statistically significant differences between the proliferating and involution strawberry hemangioma. There were no statistically significant differences between various types of vascular malformations and normal skin. With the increasing of the expression of Bax in strawberry hemangioma, the AI increased.</p><p><b>CONCLUSION</b>These findings clearly demonstrate a much higher apoptotic activity in strawberry hemangioma than in vascular malformations and normal skin and suggest that apoptosis might be a cause of spontaneous involution of strawberry hemangioma and might not be a cause of the pathogenesis of vascular malformation. Bcl-2, Bax might play an important regulatory role in apoptosis in endothelial cells of strawberry hemangioma.</p>

Enzyme-amplified time-resolved fluorescence detection for nucleic acid hybridization assays / 中国医学科学院学报

<p><b>OBJECTIVE</b>To develop a new nonisotopic detection method of enzyme-amplified time-resolved fluorescence (EATRF) or enzyme-amplified lanthanide luminescence (EALL) for nucleic acid hybridization assays, which can be applied extensively in clinical diagnosis.</p><p><b>METHODS</b>The method combines the high affinity of biotin-streptavidin system, amplification of enzyme, and inherent advantage of lanthanide chelate with the background elimination of time-resolved fluorescence detection. The conversion of 5-fluorosalicyl phosphate to 5-fluorosalicylic acid (5-FSA) by alkaline phosphatase. The salicylic acid product forms a luminescent ternary chelate with Tb3+ and EDTA.</p><p><b>RESULTS</b>The dynamic range of the standard curve of EATRFA for nucleic acid hybridization assay was very wide, the range was more than third order of magnitude. The detection sensitivity was about 10 pg of target sequence. When the known target sequence was 20, 10 and 2 ng, the ratio of measured amount to known amount was 110%, 90% and 115% respectively. The main experimental conditions, for example, the irradiating time of ultraviolet rays, the concentrations of biotinylated probe, AP-SA, 5-FSAP and Tb-EDTA and the methods of washing in the related steps, have been optimized. A new stable technology of fluorescence has been developted.</p><p><b>CONCLUSIONS</b>EATRF detection for nucleic acid hybridization assays is a new sensitive simple method, which has a great prospect.</p>