[Clinical analysis of rituximab-induced interstitial lung disease].

Objective: To investigate the clinical characteristics, diagnosis-treatment points and prognosis of rituximab-induced interstitial lung disease (R-ILD), and to improve the recognition of this disease. Methods: The clinical data on 4 cases of R-ILD were analyzed retrospectively, and the related literatures were reviewed. The literature review was carried out respectively in Wanfang Data, CNKI and PubMed by October 2016 with"rituximab"and"interstitial lung disease"or"interstitial pneumonitis"as the search terms. Results: The all 4 patients received chemotherapy including rituximab, had respiratory symptoms after 2 to 5 cycles chemotherapy respectively. The chest computerized tomography findings of all 4 cases showed diffuse ground glass opacities. In all of the patients, the diagnosis of R-ILD was made and glucocorticoids therapy was initiated. After treatment, the clinical symptoms improved promptly and follow-up chest computerized tomography showed pulmonary lesions significantly resolved. Literature review found 48 articles (2 reviews, 6 original articles, 39 case reports and 1 other article) . 50 cases of R-ILD were collected and the chief complaint were dyspnea, cough and fever. The ground-glass pattern on the CT scan of the chest was the important feature of this disease. Therapy included glucocorticoids, discontinuation of rituximab, and any other clinically necessary measures. Conclusions: Rituximab can cause interstitial lung disease. The diagnosis relies on clinical manifestation and radiological findings. The good prognosis depends on prompt discontinuation of rituximab and treatment with glucocorticoids.

[Analysis of mental state of allergic rhinitis patients in Chengdu city by symptom check list 90 (SCL-90) scale].

Objective: To analyse the mental state of patients with allergic rhinitis (AR) in Chengdu. Methods: One thousand five hundred and thirty-six AR patients from Sichuan Provincial Integrated Traditional Chinese and Western Medicine Hospital, West China Hospital of Sichuan University, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan People's Hospital, Sichuan Second Hospital of Traditional Chinese Medicine were selected from July 2013 to January 2018. Eight hundred and twenty-seven patients were screened into study group by inclusion and exclusion standards. The symptom check list 90 (SCL-90) was used to group and score the mental state of these patients according to nine classification criteria: gender, BMI, age, marital status, monthly salary, disease duration, living environment, education level and working environment. Then, the scores were compared within groups. Inter-group comparison was made between the study group and the Chinese norm, and the positive factors for psychological disorders were extracted. Four symptoms in the study group, i.e. nasal itching, sneezing, clear discharge and nasal congestion, were scored on the visual analogue scale (VAS). SPSS 19.0 software was used to carry out statistical analysis. Partial correlation analysis was performed between the positive factors and the symptom scores by multiple regression statistical method. Results: The total score of SCL-90 in the study group was 2.64±0.25, which was accorded with mild to moderate mental health impairment. There were 124 (15.0%) without mental health damage, 176 (21.3%) with mild damage, 474 (57.3%) with mild to moderate damage, 41 (5.0%) with moderate to severe damage and 12 (1.4%) with severe damage. The in-group comparison showed that the top three categories of different items were the living environment, gender and working environment. The scores of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, psychosis, other (sleep, diet) and total average score of urban residents were higher than that of country residents (3.29±0.61 vs 2.65±0.50, 2.81±0.77 vs 2.05±0.38, 3.10±0.19 vs 2.49±0.67, 3.40±0.84 vs 2.49±0.70, 3.04±0.64 vs 2.33±0.51, 3.02±0.55 vs 2.40±0.77, 3.40±0.41 vs 2.52±0.77, 2.91±0.11 vs 2.29±0.40, Z value was 4.88, 5.25, 4.57, 5.91, 5.09, 4.63, 5.55, -4.55, respectively, all P<0.05). Women scored higher than man for somatization, interpersonal sensitivity, depression and others (2.66±0.51 vs 2.00±0.45, 3.37±0.47 vs 2.63±0.51, 3.44±0.57 vs 2.85±0.52, 3.47±0.36 vs 2.76±0.45, Z value was -5.10, -5.51, -4.86, -5.28, respectively, all P<0.05). The scores of somatization, interpersonal sensitivity, psychosis and other (sleep, diet) were higher in the indoor group than those in the outdoor group (3.49±0.64 vs 2.78±0.46, 3.33±0.30 vs 2.56±0.68, 3.28±0.60 vs 2.67±0.31, 3.50±0.85 vs 2.85±0.37, Z value was 5.31, 5.79, 4.89, 5.00, respectively, all P<0.05). The outdoor group scored higher on obsessive-compulsive symptoms, anxiety and hostility (3.44±0.40 vs 2.83±0.35, 3.40±0.50 vs 2.57±0.93, 3.34±0.88 vs 2.69±0.56, Z value was 4.96, 6.22, 5.08, respectively, all P<0.05). The inter-group comparison found that depression, anxiety, psychosis and other (sleep, diet) could be partially correlated with VAS scores as 4 positive factors. The results of partial correlation analysis showed that depression was positively correlated with sneezing and nasal runny discharge, anxiety was positively correlated with nasal itching and nasal obstruction, psychosis was positively correlated with nasal itching and sneezing, and other (sleep, diet) was positively correlated with nasal runny discharge and nasal obstruction. Conclusion: AR patients have mild to moderate mental health impairments, which are correlated with AR symptoms.

Vascular anastomosis and two-stage reconstruction of the gut in a living-related small bowel transplant recipient: a case report.

AIM: We sought to discuss vascular anastomosis and gut reconstruction in a living-related small bowel transplantation recipient. METHODS: Living-related small bowel transplantation was performed successfully on a boy with short gut syndrome in two stages. In the first stage, 120 cm, of his mother's ileum was implanted into the recipient with the artery and vein anastomosed to the recipient's sigmoid artery and inferior mesenteric vein, respectively. The two ends of the implanted intestine were constructed as stomas. In the second stage, reconstruction of the continuity of the digestive tract was performed at 188 days after the initial transplantation. The residual small bowel was transected and both ends were anastomosed to the proximal and distal end of the graft in end-to-side fashion. The stomas were closed 30 and 43 days later. RESULTS: Both procedures were successful. Postoperative cytomegalovirus infection and acute rejection occurred successively and were controlled. No leakage of the reconstructed gut or other complications developed after the second procedure. The recipient is alive at 15 months with 8 kg an increase in weight. He is caring for himself independently and has a half-liquid diet, sometimes supplied with auxiliary enteral nutrition. A d-xylose test increased from 4.25% to 25% after the small bowel transplantation. CONCLUSIONS: Vascular anastomoses should be performed according to the state of graft and the recipient. The portal route is the first choice when possible. A two-stage gut reconstruction could decrease the incidence of complications, and offer a useful method in living-related small bowel transplantation.

A comparative study on essential oil components of wild and cultivated Atractylodes lancea and A. chinensis.

To clarify the variation in the pharmacologically active components of the essential oil contained in the rhizomes of Atractylodes lancea and A. chinensis growing in China, we transplanted the rhizomes of the wild plants from 18 populations, including A. koreana, in the same experimental field. After two or three years' cultivation, main essential oil components, i.e., the sesquiterpenes: elemol (1), atractylon (2), hinesol (3), beta-eudesmol (4), selina-4(14),7(11)-dien-8-one (5), and the polyacetylene of atractylodin (6) were determined by capillary gas chromatography. The analytical data of 306 cultivated plants were compared with plants collected in their habitat. A. lancea varied significantly in the contents of the components after cultivation; however, the correlation coefficient in the contents of 3, 4, and 6 between the wild and cultivated plants were 0.985, 0.954, and 0.945, respectively (p < 0.001). Compared to this, A. chinensis had constant content values. Three types of A. lancea and two types of A. chinensis, which are distinguished by the characteristics of the components in the wild conditions, were statistically recognized after cultivation. From these results, it was determined that the geographical variation in the components of these species mainly reflects genetic variability.