Analysis of 73 emergency visits in a university hospital in Beijing / 中国学校卫生

Objective@#To understand the current situation regarding emergency visits to a university hospital in Beijing, and to provide a basis for the standardized construction and formulation of emergency visit measures to university hospitals.@*Methods@#This study carried out a retrospective investigation and analysis of 73 emergency visits from September 2020 to December 2022 at a university hospital in Beijing.@*Results@#A total of 17 cases(23.3%) exhibited the most common of symptoms associated with convulsions during emergency visits to university hospital, while nine cases of abdominal pain(12.3%) and eight cases of dizziness( 11.0 %) were recorded. The proportion of males and females who presented to the emergency department was 60.3% and 39.7%, respectively. The top three diseases among emergency department outpatients included nervous system diseases(40 cases), gynecological diseases(seven cases), depression and alcoholism(six cases). The peak number of emergency visits occurred in April, May, September and November. The most frequent emergency visits presented from 13:00 to 18:00(32.9%), followed by 7:00 to 12:00(30.1%). Following emergency care, 12 cases improved, 54 cases were transferred to higher level hospitals for treatment, 2 depressive patients were taken home, 5 cases refused referral.@*Conclusion@#University hospitals should develop emergency plans for diseases related to emergency visits, provide targeted training for doctors and health education for teachers and students, and improve the emergency treatment capabilities.

Phenotypic and genetic analysis of a family affected with microvillus inclusion disease / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To explore the clinical features and mutations of MYO5B gene in a family affected with microvillus inclusion disease.</p><p><b>METHODS</b>Clinical data of an infant affected with microvillus inclusion disease was collected. Genomic DNA was extracted from peripheral blood samples from the patient and her parents. PCR amplification and Sanger sequencing were performed to analyze all the exons and their flanking sequences of the MYO5B gene.</p><p><b>RESULTS</b>The patient presented with complicated manifestations including respiratory distress syndrome, dehydration, acidosis, bowel dilatation, liver and kidney dysfunction, and severe and intractable diarrhea. A compound mutation of the MYO5B gene, i.e., IVS37-1G>C/c.2729_2731delC (p.R911Afs916X), was discovered in the patient. The former was a splice-site mutation inherited from the mother, while the latter was a frameshift mutation inherited from the father. Both were not reported previously.</p><p><b>CONCLUSION</b>Based on the clinical and molecular evidence, the patient was diagnosed with microvillus inclusion disease. Above finding has expanded the mutation spectrum of the MYO5B gene, which can provide valuable information for genetic counseling for the family.</p>

Myotomy of Distal Esophagus Influences Proximal Esophageal Contraction and Upper Esophageal Sphincter Relaxation in Patients with Achalasia After Peroral Endoscopic Myotomy

BACKGROUND/AIMS: The motility change after peroral endoscopic myotomy (POEM) in achalasia is currently focused on lower esophageal sphincter (LES). This study aims to investigate the correlation of motility response between distal and proximal esophagus after POEM. METHODS: A total of 32 achalasia patients who received POEM and high-resolution manometry (HRM) were included for analysis. Eckardt score was used to assess symptom improvement. HRM was applied for studying motility. Main parameters analyzed were (1) LES: resting pressure (restP), 4-second integrated relaxation pressure; (2) esophageal body (EB): contractile integral of distal segment with myotomy (CI-DM) and proximal segment without myotomy (CI-PNM); and (3) upper esophageal sphincter (UES): relaxation pressure (UES-RP). RESULTS: There were 6 type I, 17 type II, and 9 type III achalasia patients included for analysis. (1) Eckardt score, LES tone, CI-DM, CI-PNM and UES-RP were reduced remarkably after POEM (P < 0.001). (2) no significant correlation was noted between LES tone and contractile intergral of EB. (3) a positive linear correlation of CI-DM and CI-PNM changes was detected (P < 0.001). (4) the change of UES-RP was positively correlated with the change of contractile integral of EB (P < 0.001). CONCLUSIONS: Myotomy of the distal esophagus would attenuate proximal EB contraction and assist UES relaxation in achalasia patients after POEM.

Effect of recombinant human granulocyte/macrophage colonystimulating factor combined with nano-silver on deep burn degreen Ⅱ about inflammation / 重庆医学

Objective To observe the effect of recombinant human granulocyte/macrophage colonystimulating factor (rhGM-CSF) combined with nano-silver as a treatment on deep burn degreen Ⅱ about inflammation .Methods The burn model was built with Wistar rats .They were randomly divided into four groups ,petrolatum treatment (group A ,n= 30) ,nano-silver treatment (group B ,n=30) ,rhGM-CSF treatment(group C ,n=30) ,and rhGM-CSF combined with nano-silver treatment(group D ,n=30) . observation the inflammatory reaction ,and culture bacteria on wound of the four groups at 1st ,4th ,7th ,10th ,14th ,21th day after treatment were made .The level of IL-2 and IL-8 were measured in serums with ELISA .Results The inflammatory reaction:group A>group B>group C>group D ;Bacterias were observed in group A ,group B/C and group D at 4th ,10th ,14th day respectively af-ter treatment .The number of bacterial growed in group D was less than in group A ,group B and group C .The numbers of bacterial growed in group B and group C were less than in group A .And after 10 ,14 ,21 days treatment ,there was significantly statistical difference(P0 .05) .After other days treatment ,there was significantly statistical difference(P<0 .05) .There was signifi-cantly statistical difference in every group at each day of the IL-8 levele except A and B group ,B and C group ,C and D group at 1st day (P<0 .05) .Conclusion rhGM-CSF combined with nano-silver treatment could alleviate inflammatory reaction ,and be better than rhGM-CSF or nano-silver alone .

Effect of recombinant human granulocyte/macrophage colonystimulating factor combined with nano-silver for deep burn degreen Ⅱ about treatment / 实用医学杂志

Objective To observe the effect of recombinant human granulocyte/macrophage colonystimulating factor (rhGM-CSF) combined with nano-silver for deep burn degreen Ⅱ. Methods The burn model were done with Wistar rats. They were randomly divided into four groups , group A (n = 30): petrolatum treatment, group B(n = 30): nano-silver treatment, group C(n = 30): rhGM-CSF treatment, and group D(n =30): rhGM-CSF combined with nano-silver treatment. The healing rates of the four groups were observed on postburn day 1, 4, 7, 10, 14, 21. Meanwhile the levels of VEGF and EGF in serums were measured with ELISA. Results All groups started to heal on postburn day 10. Group A had inflammation obviously , and group D moderately. There were significant difference in the healing retes on postburn day 10 , 14, 21 between four groups (P < 0.05). The level of VEGF in group A peaked on postburn day 21 (25.76 ± 1.46)pg/mL, but the levels of VEGF in group B, group C and group D peaked on postburn day 14[(29.73 ± 1.58)pg/mL, (38.91 ± 2.38)pg/mL, (43.54 ± 1.28)pg/mL]. On postburn day 4, 7, 10, 14, 21, there were significant difference(P <0.05). The level of EGF peaked on postburn day 21 in all groups [(0.72 ± 0.14)ng/mL, (0.93 ± 0.13)ng/mL, (1.18 ± 0.16)ng/mL, (1.50 ± 0.15)ng/mL]. There were significant difference on postburn day 7, 10, 14, 21 between four groups (P < 0.05). Conclusions rhGM-CSF combined with nano-silver treatment could promote wound healing, and be better than rhGM-CSF and nano-silver singly.

Characteristics and significance of atypical flow cytometric immunophenotype in plasma cell myeloma / 中华检验医学杂志

Objective To investigate the characteristics and significance of atypical flow cytometric immunophenotype in plasma cell myeloma.Methods Using case-control study , 48 cases with atypical immunophenotype of plasma cell myeloma and 42 cases as control group were studied by flow cytometry , the former cases were classified into three groups according to the expression of CD 38, CD138, CD19, CD56 :CD38 +/CD138 +/CD19 +/CD56 +, CD38 +/CD138 +/CD19 +/CD56 -, CD38 +/CD138 +/CD19 -/CD56 -.And compare the three groups with intracellular immunoglobulin light chain (cKappa, cLambda) , bone marrow morphology and immunofixation.The positive rate was compared with chi-square test.Results Bone marrow plasma cells showed expression of particular antigens in the following proportion of the 48 cases:CD45 29.17%, CD38 100%, CD138 100%, CD19 95.83%, CD56 43.75%, cKappa 43.75%and cLambda 56.25%.And in the three groups , the expression of monoclonal immunoglobulin were 43.75%, 52.08%and 4.17%, which bone marrow morphology and immunofixation were 57.14%,80%, 100%and 71.43%,88%,100%.The positive rate of flow cytometry , bone marrow morphology and serum immunofixation electrophoresis were 100%, 70.83% and 81.25%.While the expression of particular antigens in the control group were:CD45 47.62%, CD38 100%, CD138 100%, CD19 100%, CD56 0%, cKappa 100% and cLambda 100%.And no abnormalities were detected in bone marrow morphology and immunofixation.Conclusions Compared with the bone marrow morphology and immunofixation , multiparameter flow cytometry has more helpful to find out atypical immune phenotype of plasma cell myeloma, and differentiate malignant and benign plasma cell , contributes to the diagnosis of clinical plasma cell myeloma, prognosis and treatment monitoring.

The value of combined detection of PCA3 mRNA and PSA mRNA in peripheral blood of patients with prostate cancer / 中华检验医学杂志

Objective To evaluate the application value of combined detection of PCA3 and PSA mRNA in peripheral blood of patients with prostate cancer(PCa) for evaluation of mien)metastasis. Methods PCA3 and PSA mRNA were detected by duplex real time quantitative RT-PCR in a total of 49 PCa and 71 benign protatic hyperplasia (BPH) patients' peripheral blood. The diagnostic value was analyzed by receiver operative characteristic(ROC) curve. Results The levels of PCA3 mRNA in PCa patients were significantly higher than those in BPH patients [2 362( <30-7 421 ) copies/ml vs <30 copies/M, Z = -6. 66, P < 0. 01 ], and the same to PSA mRNA [3 425 ( 908-36 639 ) copies/ml vs < 200 copies/ml, Z = - 6. 40, P<0. 01 ]. The positive rate of PCA3 and PSA mRNA in peripheral blood was positively correlated with clinical stage[clinical stage B: 30.0% (3/10), C: 60.0% (9/15) and 86.7% (13/15), D: 91.7% (22/24) and 91.7% (22/24) ,Chi-square = 13. 534 and 16. 541, P <0. 01, respectively]. Meanwhile, the positive rate of PCA3 mRNA and PSA mRNA was also increased with the increase of Gleason score[ Gleason score of 2 to 4 : 20.0% (1/5) and 40. 0% (2/5) ;5 to 7 : 66.7% (12/18) and 72. 2% ( 13/18 ) ;8 to 10 : 84. 6% (22/26) and 92.3% ( 24/26 ) ;Chi-square = 8. 895 and 8. 015, P < 0. 05, respectively ]. ROC analysis showed that the sensitivities for PCA3 and PSA mRNA were 69. 4% (34/49) and 81.7% (40/49) and the specificities was 90. 1% (64/71) and 77.5% (55/71), respectively, when the cut-off value was 846 copies/ml for PCA3 mRNA and 280 copies/ml for PSA mRNA. Meanwhile, the sensitivity can reach to 85.7% (42/49) when the detection of PCA3 and PSA mRNA were combined. However, the specificity was decreased to 76. 1% (54/71). For the diagnosis of PCa micrometastasis, the sensitivity and specificity for PCA3 mRNA was 90.9% (20/22) and 84.7% (11/13), respectively. Conclusions PCA3 and PSA mRNA in peripheral blood are useful markers for PCa diagnosis. Simultaneous detection for PCA3 and PSA mRNA is more helpful for PCa diagnosis. Meanwhile, detection of PCA3 mRNA is a useful marker for diagnosing PCa micrometastasis.

Relationship between Mycoplasma pneumoniae infection and disease activity of ankylosing spondylitis / 中华风湿病学杂志

Objective To investigate the association of Mycoplasma pneumoniae(MP) infection with disease activity of ankylosing spondylitis. Methods A total of 158 subjects in our hospital were enrolled in this study, including patients with ankylosing spondylitis(AS, n=66), rheumatoid arthritis (RA, n=31),osteoarthritis(OA, n=25) and normal controls(NC, n=36). MP infection was defined as anti-MP IgM antibody positive. Anti-MP IgM antibodies were determined by a mycoplasma pneumoniae(Mac strain)membrane-based agglutination test. AS patients were divided into two groups: MP infection group and non-MP infection group. T-test was used for statistical analysis of age, blood white cells, ESR, CRP, immunoglobulin, BASDAI index, global assessment on VAS scale, Schober test and chest expansion reflecting spinal mobility.χ2-test was used to compare the positive rate of MP infection in different groups. Gender difference and prevalence of clinical infection in past four weeks between MP infection and MP-free group in AS patients was also compared. Ridit analysis was used to analyze the association of MP infection with degree of sacroiliac damage on CT. Results The prevalence of MP infection in AS (52%, 34/66) was much higher than that in rheumatoid arthritis (RA, 6%, P＜0.01 ), osteoarthritis(OA, 4%, P＜0.01 ) and normal controls (NC, 11%, P＜0.01) . Compared with the non-MP infection group, the MP infection group had more active disease in term of BASDAI(4.0±1.1 vs 3.0±1.9, P=0.017), ESR[(44±32) mm/1h vs (28±23) mm/1h, P=0.029], CRP [(40±38) mg/L vs (22±21) mg/L, P=0.025] serum total IgG level [(18±3) g/L vs (16±5) g/L, P=0.027],but not in serum total IgA and IgM. Regarding to the sacroiliac joint and spinal mobility, MP infection group did not exhibit any association with the sacroiliac grading on CT, Schober test and expansion. In AS patients with MP infection, only 44.1%(15/34) was complicated by clinical manifestations of upper respiratory tract in the past 4 weeks. However, a higher prevalence of MP infection was found in AS patients with clinical manifestation of upper respiratory tract, compared with those with negative clinical manifestation(71% vs 42%,P=0.027). Conclusion Mycoplasma pneumoniae is the most common reported pathogen in ankylosing spondylitis and relates to the disease activity of AS. MP infection is probably a principal triggering factor in the pathogenesis of AS.