摘要:目的:調查呼和浩特市地區變應性疾病患者常見變應原的分布情況。方法:以720例變應性疾病的患者為研究對象,進行11種吸入性變應原皮膚點刺試驗,測定致敏變應原。結果:720例變應性疾病患者中577例(80.1％)變應原測試有陽性反應。577例陽性病例中艾蒿陽性率最高,315例(54.6％),其次是螨蟲254例(44.0％)。結論:艾蒿、螨蟲是呼和浩特市地區變應性疾病的最常見變應原。Abstract: Objective: To study the distribution of common allergens among patients of allergic diseases in Hohhot area.Method: Seven hundred and twenty cases of allergic disease were selected and 11 items of inhaled allergen skin prick tests were carried out to determine the allergens.Results:Five hundred and seventyseven patients out of the 720 (801％) reacted positively to allergen tests.Three hundreds aned fifty cases (546％) were positive in the mugwort,254 cases (440％) were positive in the mites.Conclusion: Mugwort and mites are the most common allergens in Hohhot area.
Objective To evaluate if performing thyroidectomy through small incision has any notable aesthetic impact on patients compared with larger incision. Methods Thirty consecutive patients underwent thyroidectomy were enrolled from March 2008 to June 2008 in this prospective randomized pilot study. The incision length was 6 cm in the small incision group and 9 cm in the larger incision group. After 3 years follow-up，the scar aesthetics were evaluated by patients and surgeons using the Patient and Observer Scar Assessment Scale （POSAS），Vancouver Scar Scale （VSS），respectively. Digital photographs about scars were taken and assessed by non-research related viewers. Results There were 13 cases who received scar aesthetic assessment in both groups. The demographic characteristics of both groups were comparative. The overall patients’ satisfactions for the small incision group and the larger incision group were （2.5±1.9） scores and （2.2±1.5）scores， respectively （P=0.55）. There were no significant differences in scar assessment scale score as for other scar assessment scales （including VSS score，PSAS score，and OSAS score） between the two groups. The evaluation of digital photographs about scars by non-research related viewers was no significant difference （P＞0.05）. Conclusion Larger cervical scar in thyroidectomy does not decrease patients’ satisfaction with their scar results.
Objective To investigate the indications and prevention of complications of total thyroidectomy in the management of thyroid diseases. Methods Eighty five patients who received total thyroidectomy between Jan. 2009 and Dec. 2011 were retrospectively analyzed with regard to the surgical procedures and postoperative complications. There were 46 thyroid cancers， 38 nodular goiters， and 1 Hashimoto thyroiditis. Results The postoperative pathological exam-inations revealed that 9 （19.6%） of 46 thyroid cancers were bilateral， and all of nodular goiters were also bilateral multiple nodule. Bilateral recurrent laryngeal nerves were exposed in all of the patients in which 4 recurrent laryngeal nerves were invaded by cancer and 1 was sacrificed. There were 5 patients whose parathyroids were not identified and protected during the operation. Two patients developed postoperative bleeding and needed reoperation， 6 patients developed hoarseness of whom 5 patients recovered except for the one whose nerve was sacrificed. And in terms of hypoparathyroidism， 33 （38.8%） patients developed transient hypocalcemia related symptoms. The permanent hypoparathyroidism occurred only in 2 patients. Conclusions Total thyroidectomy is a safe procedure in the management of thyroid cancer and bilateral nodular goiter. Exposing the recurrent laryngeal nerve and parathyroid is an effective method to prevent major complica-tions. Invasion of recurrent laryngeal nerve by thyroid cancer might not lead to hoarseness.
Objective To evaluate the impact of total thyroidectomy on health-related quality of life （HRQOL） in patients with nodular goiter. Methods The patients who underwent total thyroidectomy from Jan. 2009 to Dec. 2011 in our hospital were retrospectively analyzed with regard to the quality of life （total thyroidectomy group）. The patients with similar demographic features who underwent hemithyroidectomy during the same period were matched as control （hemi-thyroidectomy group）. The validated HRQOL instrument， which was the Euro quality of life-5D （EQ-5D）， was applied to measure the HRQOL. Comparison of HRQOL in patients of 2 groups was performed， meanwhile， the data of total thyroidectomy group was compared with data of normal population who were obtained from The Forth National Health Survey. Results There were 26 and 28 valid questionnaires returned for the total thyroidectomy group and hemithyroi-dectomy group respectively. The demographic features of patients in 2 groups were comparable. No significant variancecould be found between the 2 groups that there were no significant differences on the mobility， self-care， usual activities，pain/discomfort， anxiety/depression， and visual analogous scales （P＞0.05）. Furthermore， no significant differences in HRQOL were found in EQ-5D questionnaire compared with normal population derived from The Forth National Health Survey （P＞0.05）， except that there were more patients complained of moderate and severe pain/discomfort in the total thyroidectomy group 〔30.8% （8/26） vs.9.2% （16 330/177 501）， P＜0.01〕. Conclusion Total thyroidectomy appears to have little impact on the quality of life in the patients with nodular goiter.
Objective To investigate the threshold value for postoperative parathyroid hormone （PTH） that can predict the development of symptomatic hypocalcemia. Methods The patients received total thyroidectomy and all the operations performed by the same team from June 2010 to December 2011 in the thyroid and breast group of department of general surgery，Xuanwu Hospital of Capital Medical University were enrolled in this prospective study. Serum PTH and calcium were tested at 1-hour postoperatively and thereafter every day during hospitalization. Symptoms of hypocalcemia were recorded. Receiver operator characteristic curve was plotted to test the value of PTH assay to predict symptomatic hypocalcemia. Results There were 45 consecutive patients recruited in this prospective study，9 （20.0%） patients remained normocalcemic and 36 （80.0%） patients developed hypocalcemia postoperatively. There were 19 （42.2%） patients who developed symptoms associated with hypocalcemia and needed calcium supplement. The postoperative PTHs for normocalcemic （n=9），asymptomatic （n=17），and symptomatic （n=19） hypocalcemia patients groups were （40.5±23.7） ng/L，（18.3±9.1） ng/L，and （7.6±4.2） ng/L，respectively （P＜0.001）. The PTH value less than 13.4 ng/L could easily predict who were at high risk to develop symptomatic hypocalcemia with sensitivity of 94.7% and specificity of 76.9%. Conclusions This study suggests that a 1-hour postoperative PTH level at 13.4 ng/L can identify those individuals at risk for developing symptomatic hypocalcemia. Therefore，we recommend early calcium supplementation for these patients to decrease their postoperative morbidity from symptomatic hypocalcemia.
Objective To investigate the feasibility and safety of laparoscopic-assisted gastrectomy for distant gastric cancer. Methods All 18 patients with distant gastric cancer receiving laparoscopic-assisted gastrectomy were analyzed. Results Laparoscopic-assisted distal gastrectomy was performed successfully in all patients. The mean operation time was (291.33±19.61) min. The mean blood loss was (151.32±71.78) ml. The mean numbers of harvested lymph node were 14.57±3.11. The mean time of gastrointestinal function recovery was (3.46±0.93) d, the mean out of bed activity time was (1.75±0.45) d. All patients were followed up for 1-24 months, mean 11 months. No local recurrence, trocar implant or distant metastasis happened. Conclusion Laparoscopic-assisted gastrectomy is a feasible and safe surgical procedure combined with minimal trauma and fast recovery.
Objective To evaluate the efficacy, safety and economical values of nucleic acid/nueleotides for clinical nutritional support and immune treatment. Methods The following electronic databases were searched: Chinese Biomedicine database (CBM), MEDLINE, EMBASE and SCI. Data were extracted by two reviewers. Applied RevMan 4.1 for statistical analyse. Results Forty-six randomized controlled trials were identified, involving nucleic acids/nucleotides for clinical nutritional support, infant feed, immune treatment. Eighteen randomized trials comparing the use of immunonutrition which comprises nucleotides with standard enteral nutrition in surgical and critical ill patients. Combined analysis directed that immunonutrition therapy decrease infection events, length of hospitalization and the cost. Only one trial reported the effects of adding nucleotides to breast milk substitute, but there is no valuable results for clinical practice. Twenty-seven low quality trials compared the use of "immune RNA (iRNA)" with standard methods in hepatitis, carcinoma and burn patients, combined analysis directed that there are not valid evidences to confirm the value of iRNA. Conclusions Immunonutrition may decrease infection rates, length of hospitalisation and cost in surgery and critical ill patients, but we can not affirm the role of the nucleotides in irmnunonutrition. No evidences support the point of adding nucteotides in breast milk substitute. Also, we can not affirm the role of iRNA in clinical immune regulation treatment. There are no available evidences in nucleic acids for caducity prevention and improvement of aging people’s health. Consequently, we advice Chinese health officials to enhance the management for applying "nucleic acids nutrients".
目的 比較外固定支架與鎖定加壓鋼板（LCP）治療橈骨遠端die-punch骨折的療效及適應證。 方法 2007年1月－2011年1月，分別采用外固定支架和LCP治療橈骨遠端die-punch骨折32例36側，其中LCP固定19側，外固定支架固定17側。兩組患者性別、年齡、致傷原因、骨折分類、傷后至入院時間等一般資料比較差異無統計學意義（P＞0.05）。術中對塌陷的關節面均采取撬撥植骨的方法恢復橈腕關節，克氏針固定較大骨折塊。比較兩種方法手術前后掌傾角、尺偏角、橈腕關節面恢復情況、骨折愈合時間，術后腕關節活動范圍等。 結果 兩組患者手術切口均Ⅰ期愈合，無感染發生。患者術后均獲隨訪，隨訪時間6～24個月，平均13個月。所有患者骨折愈合良好，愈合時間、術后6個月X線片掌傾角、尺偏角兩組間差異均無統計學意義（P＞0.05）；術后6個月腕關節尺偏活動度分別為（20.8 ± 3.6）°和（18.0 ± 2.8）°，LCP組優于外固定支架組（P＜0.05）；LCP組和外固定支架組橈骨高度分別為（10.9 ± 2.8）mm和（13.4 ± 2.3）mm，Gartland-Werley評分分別為（5.3 ± 2.4）分和（8.4 ± 3.6）分，兩組差異有統計學意義（P＜0.05）。 結論 對于橈骨遠端die-punch骨折，LCP可提供有效固定及早期活動，但對于關節面的塌陷及橈骨高度的恢復，外固定支架固定可提供良好的支撐作用。對于嚴重die-punch骨折可聯合運用LCP和外固定支架等技術。
Objective To investigate the effect of caveolion-1 on the growth and proliferation in human breastcancer MCF7 cell in vitro and in vivo and approach its mechanisms. Methods The plasmid pCI-neo-cav-1 and its corres-ponding empty vector （pCI-neo） were transfected into MCF7 cell line. The expressions of caveolin-1 and vascular endoth-elial growth factor （VEGF） in transfectants were subsequently confirmed by Western blot analysis. A pair of monoclonal cell lines， MCF7/cav-1 and MCF7/vec， were chose for future studies. The colony formation ability of tumor cells was detected by anchorage-independent growth assay. Xenograft tumor models in nude mice were established. Immunohisto-chemistry was used to characterize Ki-67 and VEGF levels in the tumors tissues. Results Caveolin-1 expression was up-regulated in the MCF7/cav-1 cell as compared with the MCF7/vec cell （P＜0.01） and the MCF7 cell （P＜0.01）. Caveolin-1 overexpression markedly reduced the capacity of the cells to form colonies in soft agar （P＜0.01）. Compared with the MCF7/vec cell， VEGF protein expression reduced in the MCF7/cav-1 cell （P＜0.01）. In vivo experiments in nude mice， the overexpression of caveolin-1 resulted in significant growth inhibition of the xenograft breast tumors. The Ki-67 staining was weak and the VEGF staining was negative by immunohistochemistry that indicated the caveolin-1 inhibited the proliferation in human breast cancer MCF7 cell. Conclusion The caveolin-1 might inhibit the growth and proliferation in human breast cancer MCF7 cell through suppressing activation of VEGF signaling pathway.
Objective To investigate the anti-rejection effect and the mechanism of triptolide （TPT） on islet allo- grafts in a murine model. Methods BALB/c mice were used as islet donor. C57BL/6 mice were rendered diabetic by streptozotocin （STZ） injection， and transplanted with islets under the left kidney capsule. The recipients were randomly （method of random digits table） divided into three groups （n=8）. The mice in the treatment groups were injected intrap-eritoneally with TPT at 50 μg/kg （low-dose TPT group， L-TPT group） or 100 μg/kg （high-dose TPT group， H-TPT group） daily in the first 5 days and then on alternate days until 14 days；while the mice in control group were given vehicles （1% tween 80）. Blood glucose after operation were monitored. The grafts were defined as rejection when two consecutive reading of blood glucose＞20 mmol/L. The left kidney of three recipients in each group were resected for pathological examination. The proportion of CD4＋CD25＋Foxp3＋ regulatory T cells in spleen tissues were tested by flow cytometry. Results The median survival time of islet allografts from the control group， L-TPT group， and H-TPT group were 12.6 days （9-16 days）， 21.4 days （14-27 days） ， and 27.6 days （19-34 days）， respectivly. The percentageof CD4＋CD25＋Foxp3＋regulatory T cells in spleen tissues of three groups were （5.2±0.6）%， （12.0±1.3）%， and（15.7±1.8）%， respectivly. Compared with control group， the median survival time of islet transplantation in mice exte-nded and the proportion of CD4＋CD25＋Foxp3＋ regulatory T cells in spleen tissues increased （P＜0.05）. Conclusions TPT could increase the percentage of CD4＋CD25＋Foxp3＋ regulatory T cells， reduce the rejection after islet transplanta-tion， and prolong the survival time of islet transplantation in mice. The immunosuppressive effect of TPT shows a dose-dependent.