ObjectiveTo study the diagnosis value of anti-SSa (including anti-Ro52 and anti-Ro60). MethodsAntibodies of ENA (including Sm, Ro52, Ro60, SSb, RNP, Scl-70, Jo-1 and Rib-P) from 23145 patients with positive antinuclear antibody (ANA) were retrospected from January 2009 to December 2013. The relationship between anti-Ro52, anti-Ro60 and other test results and the diagnosis or symptomatic information of patients was also analyzed. ResultsThe anti-Ro60 positive rate was 35.19% (8 145/23 145), and the anti-Ro52 was 13.16% (3 046/23 145) in 23145 ANA positive cases (P<0.05). The positive percentage of anti-Ro60 was higher in anti-SSb, anti-RNP, anti-Sm and anti-Rib-P positive cases than anti-Ro52 (P<0.05); the results of anti-Ro52 negative and anti-Ro60 positive (Ro52-Ro60+) had a higher percentage in autoimmune diseases, non-autoimmune disease and symptoms groups than anti-Ro52 positive and anti-Ro60 negative (Ro52+Ro60-) results (P<0.05). ConclusionThe anti-Ro60 has higher positive rate than anti-Ro52, and the sensitivity and prediction value of autoimmune diseases of anti-Ro60 are better than anti-Ro52. But both anti-Ro60 and anti-Ro52 have poor specificity for disease diagnosis.
ObjectiveTo discuss the relationship between antinuclear antibody (ANA) fluorescence pattern detected by indirect immunity fluorescence (IIF) and antinuclear antibody profiles (including anti-dsDNA, RNP, Sm, SSa, SSb, Scl-70, Jo-1 and rib-P) in human serum. MethodsA total of 7385 cases of ANA pattern and ANA profiles were retrospectively analyzed from January 2010 to December 2013. ANA was detected by IIF substrated as HEp-2 cells, anti-dsDNA by IIF substrated as crithidia, and the other 7 antibodies by enzyme immunoblot with purified antigen. ResultsGranular pattern mostly presented as anti-RNP, anti-Sm, anti-SSa and anti-SSb (P < 0.001); homogeneous pattern was anti-dsDNA and anti-SSa (P < 0.001); nucleolus, centromere, and mixed pattern was anti-SSa (P < 0.05); cytoplasm pattern was anti-rib-P and anti-SSa (P < 0.05). But few above antibodies could be detected in Golgi, dots, rim, actin, actotropomyosin, prolifevating cell nuclear antigen (PCNA) and vementin pattern. Homogeneous pattern was shown up to 77.91% in only anti-dsDNA positive serum; granular was 96.84%, 52.01%, and 82.35% respectively in only anti-RNP or anti-SSa or anti-Sm positive. Homogeneous and nucleolus mix pattern was up to 30.53% in only anti-Scl-70 positive. Cytoplasm pattern was 50.00% and 61.54% respectively in only anti-rib-P or anti-Jo-1 positive. But no fixed relationship was found between ANA pattern and anti-SSb. ConclusionsThere is a certain relationship between ANA and antinuclear antibody profiles. Granular, homogeneous and cytoplasm pattern often can be detected more than one autoantibodies. Eight kinds of specific autoantibodies often are negative when ANA patterns are centromere, Golgi, dots, rim, actin, tropomyosin, PCNA, and vimentin. Anti-dsDNA is mainly corresponding to homogeneous, anti-RNP, anti-SSa and anti-Sm to granular, anti-Scl-70 to homogeneous and nucleoli, anti-rib-P and anti-Jo-1 to cytoplasm. The study can give suggestions for further tests application and lab result checking.
ObjectiveTo assess the safety, feasibility, and effectiveness of medical calcium sulfate (OsteoSet) mixed with powder for injection of rifampicin after radical debridement in the treatment of sacroiliac joint tuberculosis. MethodsA retrospective analysis was made on the clinical data from 27 patients with sacroiliac joint tuberculosis who underwent debridement surgery and local bone graft of OsteoSet artificial bone impregnated with powder for injection of rifampicin between August 2006 and August 2010. There were 10 males and 17 females with an average age of 35.2 years (range, 16-64 years). The mean disease duration was 7.5 months (range, 1.5-16 months). The left sacroiliac joint was involved in 16 cases, the right side in 10 cases, and both sides in 1 case; Of them, 18 cases had iliac fossa abscess and 6 cases of buttocks abscess. According to the classification system by Kim, there were 9 cases of type Ⅲ and 18 cases of type ⅠV. The preoperative Majeed score was 61.23±6.49, including good in 4 patients, general in 19 patients, and poor in 4 patients. ResultsAll patients achieved wound healing by first intention; no complications of pelvic infection, peripheral nerve injury, and lower extremity deep vein thrombosis occurred. Twenty-six patients were followed up 16 months on average (range, 12-24 months). All the patients had normal sense and movement of both lower limbs; no perineum sensory disturbance was found. One case of multi-drug resistant had local recurrence at 3 months after operation, which was cured after adjusting anti-tuberculosis drugs, nutritional support, enhancing immunity with thymopentin, and second operation. Bone union was observed at 10.5 months on average (range, 9-12 months) in 25 patients, and clinical symptoms disappeared with no recurrence or complication, and they returned to previous work. The Majeed score at last follow-up was 92.31±3.36, showing significant difference when compared with preoperative score (t=-32.76, P=0.00). The results were excellent in 22 patients, good in 4 patients, and the excellent and good rate was 100%, showing significant follow-up was 92.31±3.36, showing significant difference when compared with preoperative score (t=-32.76, P=0.00). The results were excellent in 22 patients, good in 4 patients, and the excellent and good rate was 100%, showing significant difference compared with the preoperative one (χ2=31.93, P=0.00). ConclusionBone graft interbody fusion surgery with rifampicin loaded OsteoSet is one of the effective methods to treat sacroiliac joint tuberculosis.
ObjectiveTo compare and analyze the short-term efficacy of different surgical methods for Siewert type Ⅰ and type Ⅱ esophagogastric junction carcinoma.MethodsWe selected 82 patients who accepted radical resection of esophagogastric junction carcinoma from March 2015 to March 2018 in our department, including 53 males and 29 females, aged 48-72 (61±6) years. The patients were divided into four groups according to the surgical method: a left thoracotomy group (n=14), a laparoscopic left small thoracotomy group (n=33), a thoracoscopic Ivor-Lewis group (n=17), and a thoracoscopic McKeown group (n=18). Their clinical characteristics, operative situations, postoperative complications and survival rate were analyzed.ResultsAmong the four groups, the left thoracotomy group cost the shortest operation time, followed by laparoscopic left small thoracotomy group, thoracoscopic McKeown group and thoracoscopic Ivor-Lewis group. The thoracoscopic McKeown group/laparoscopic left small thoracotomy group had the least bleeding. The fewest lymph nodes were dissected in the left thoracotomy group and the most in the thoracoscopic McKeown group. The laparoscopic left small thoracotomy group had the lowest total complication rate and the incidence of pneumonia and arrhythmia among the four groups (P<0.05). There was no significant difference in survival rate among the four groups (P>0.05).ConclusionFor Siewert type Ⅰ and type Ⅱ esophagogastric junction carcinoma, thoracoscopy combined with laparoscopic radical resection is safe and reliable. Laparoscopic left small thoracotomy has the advantages of minimal invasiveness and complete lymph node dissection, especially for the patients with poor cardiopulmonary function, which will significantly shorten operation time and reduce postoperative complications, so it is worth to be popularized.
From December 2022 to January 2023, 4 lung transplant recipients were hospitalized in the Department of Thoracic Surgery of the First Affiliated Hospital of Xi'an Jiaotong University due to COVID-19 infection after surgery, of whom 3 were cured and 1 died. The clinical manifestations were mostly characterized by elevated body temperature accompanied by shortness of breath, and indicators such as heart rate, oxygen saturation, and oxygenation index can reflect the severity of the condition. Antiviral therapy requires timely adjustments to immunosuppressive drugs, upgraded oxygen therapy, anti-bacterial and anti-fungal therapy, prone ventilation, general treatment, and anticoagulant therapy, depending on the situation. We should pay attention to monitoring during the course of the disease, and follow up closely after discharge.
ObjectiveTo systematically review the association between the IL-6 gene -634G/C polymorphism and the risk of lung cancer. MethodsDatabases including the PubMed, EMbase, CNKI and WanFang Data were searched from inception to October 2015 to collect case-control studies about the correlation between the IL-6 gene -634G/C polymorphism and the risk of lung cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 12 case-control studies concerning 3 657 lung cancer cases and 4 100 controls from 11 articles were included. The results of meta-analysis showed that there was no significant association between the -634G/C polymorphism and the risk of lung cancer (GG+GC vs. CC: OR=1.11, 95%CI 0.89 to 1.39, P=0.37; GG vs. CC+GC: OR=1.17, 95%CI 0.88 to 1.55, P=0.27; GG vs. CC: OR=1.27, 95%CI 0.93 to 1.72, P=0.13; GC vs. CC: OR=1.12, 95%CI 0.89 to 1.40, P=0.33; G vs. C: OR=1.08, 95%CI 0.89 to 1.30, P=0.43). ConclusionIL-6 gene -634G/C polymorphism may not be a risk factor of lung cancer. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.
Objective To investigate the short-term effectiveness of transverse antecubital incision in the treatment of failed closed reduction of Gartland type Ⅲ supracondylar humeral fractures (SHFs) in children. Methods Between July 2020 and April 2022, 20 children with Gartland type Ⅲ SHFs who failed in closed reduction were treated with internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision. There were 9 boys and 11 girls with an average age of 3.1 years (range, 1.1-6.0 years). The causes of injuries were fall in 12 cases and fall from height in 8 cases. The time from admission to operation ranged from 7 to 18 hours, with an average of 12.4 hours. The healing of the incision and the occurrence of complications such as nerve injury and cubitus varus were observed after operation; the elbow flexion and extension range of motion after removing the gypsum, after removing the Kirschner wire, and at last follow-up were recorded and compared, as well as the elbow flexion and extension and forearm rotation range of motion at last follow-up between healthy and affected sides; the Baumann angle was measured on the X-ray film, and the fracture healing was observed. At last follow-up, the effectiveness was evaluated according to the Flynn elbow function evaluation criteria. ResultsAll incisions healed by first intention, and there was no skin necrosis, scar contracture, ulnar nerve injury, and cubitus varus. Postoperative pain occurred in the radial-dorsal thumb in 2 cases. The gypsum was removed and elbow flexion and extension exercises were started at 2-4 weeks (mean, 2.7 weeks) after operation, and the Kirschner wire was removed at 4-5 weeks (mean, 4.3 weeks). All the 20 patients were followed up 6-16 months, with an average of 12.4 months. The fracture healing time was 4-5 weeks, with an average of 4.5 weeks, and there was no complication such as delayed healing and myositis ossificans. The flexion and extension range of motion of the elbow joint gradually improved after operation, and there were significant differences between the time after removing the gypsum, after removing the Kirschner wire, and at last follow-up (P<0.017). There was no significant difference in the flexion and extension of the elbow joint and the forearm rotation range of motion between the healthy and affected sides at last follow-up (P>0.05). There was no significant difference in Baumann angle between the time of immediate after operation, after removing the Kirschner wire, and at last follow-up (P>0.05). According to Flynn elbow function evaluation standard, 16 cases were excellent and 4 cases were good, the excellent and good rate was 100%. Conclusion The treatment of Gartland type Ⅲ SHFs in children with failed closed reduction by internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision has the advantages of complete soft tissue hinge behind the fracture for easy reduction and wire fixation, small incision, less complications, fast fracture healing, early functional recovery, reliable reduction and fixation, and can obtain satisfactory results.