FS04.1Formaldehyde allergy – clinically relevant threshold reactions

The objective of the study was to establish eliciting threshold concentrations of diazolidinyl urea (Germall II)– derived formaldehyde in formaldehyde and/or in diazolidinyl urea – sensitive patients, using a leave‐on face cream formulation in a repeated open application test (ROAT) applied to different anatomical regions.
150 patients with known formaldehyde allergy were reviewed for inclusion in the study. 108 patients were contacted and in 65 patients the formaldehyde sensitisation was reconfirmed by a patch test. Four groups of 10 formaldehyde allergic subjects were exposed to 0.05%, 0.15%, 0.3% and 0.6% diazolidinyl urea, corresponding to approximately 50, 100, 200 and 400 ppm free formaldehyde, respectively.
Additional 10 individuals allergic to the formaldehyde donor – diazolidinyl urea itself – were exposed to 0.15% diazolidinylurea, corresponding to approximately 100 ppm free formaldehyde and 10 healthy non‐allergic individuals were exposed to 0.6% of diazolidinylurea (approximately 400 ppm free formaldehyde).
A ROAT was performed in a scheduled sequence: upper arm, neck and face.
Contact allergy reactions were elicited in 39 out of 58 formaldehyde‐sensitive and in 5 out of 7 diazolidinyl urea‐sensitive individuals.
Elicitation responses were dose‐ and anatomical region – dependent.
No reactions were observed at the lowest dose, suggesting that an elicitation threshold was attained in the study.     

P34Reproducibility of the positive patch test reactions with the TRUE Test

The patch test results of patients tested at least twice at our clinic during a period of 11 years were analyzed with regard to reproducibility of the positive patch test reactions found in the first patch testing session.
A retrospective analysis of 257 patients who have been tested with the TRUE Test at least twice between 1991 and 2002 and had a minimum of one positive reaction in the first testing session was done. Test reactions were read routinely after 3 and 5–7 days.
In the first testing session a total of 299 positive reactions were found. Of these allergens, 151 (51%) stayed positive in the second test, 31 (10%) produced a doubtful reaction, 67 (22%) a negative response, and 50 (17%) were not retested because of strong positive reactions in the first test. Of the individual allergens, positive reactions from thiuram‐mix, kathon CG and colophony were the most reproducible.
If it is assumed that allergens which were not retested because of strong positive reactions would have shown positive reactions in a retest, a total of 68% of positive reactions were reproduced. A multitude of factors, such as: avoidance of relevant allergens between tests, diminished sensitivity, retesting within a period of more or less active dermatitis, different observers, methodological error, and prior false‐positive responses, influence the reproducibility of patch tests. The results will be put in perspective.     

白及多糖对酪氨酸酶活性及黑色素生成的影响

目的:观察白及多糖对酪氨酸酶(TYR)活性及黑色素形成相关蛋白TYR、小眼畸形相关转录因子(MITF)表达的影响。方法:超声提取白及多糖粗品。用不同浓度的白及多糖(0.05、0.1、0.2、0.4、0.8 g/L)和曲酸(阳性对照,0.1、0.2、0.4 g/L)作用于小鼠B16黑色素瘤细胞,用于检测细胞活性、TYR活性;各组细胞分别加入α-黑色素细胞刺激素(α-MSH)及不同浓度药物共培养后检测黑色素含量;将细胞分为空白组、模型组(α-MSH)、曲酸组及白及多糖低、中、高剂量组,予相应干预48 h后,应用Western blot检测B16细胞TYR和小眼畸形相关转录因子(MITF)的蛋白表达情况。结果:不同浓度曲酸组、白及多糖(0.05~0.8 g/L)组、空白组间的细胞活性差异无统计学意义(P0.05)。与空白组比较,白及多糖在浓度0.1~0.8 g/L对TYR的活性有显著抑制作用(P0.05,P0.01),其作用与阳性对照曲酸相当;白及多糖在浓度0.1~0.8 g/L有较高的抑制黑色素生成作用(P0.05,P0.01);白及多糖浓度0.2~0.4 g/L对TYR、MITF蛋白表达水平有明显抑制作用(P0.05)。结论:白及多糖可能通过抑制TYR的活性和蛋白表达及MITF的蛋白表达,起到抑制黑色素生成的作用。     

社会和心理学干预随机对照试验的报告规范（2018）解读

<正>随机对照试验(RCT)因其消除偏倚、平衡混杂因素、提高统计学检验的有效性等优点,被公认为是评价干预措施效果的金标准[1],逐渐推广到临床以外的社会和心理学研究领域。社会和心理学干预(SPI)旨在改善身体、心理健康和社会结局,相比临床干预类型复杂多样,并且干预间存在相互作用,结局指标也涉及多个层次(如个人、家庭和社区等)[2]。目前,对于SPI的RCT报告仍然采用RCT报告     

放疗计划平面剂量分布验证中不同分辨率对通过率的影响

目的:探讨放疗计划平面剂量分布验证中不同输出分辨率对通过率的影响。方法:选取我院2017年03月至2018年03月收治的调强放疗患者40例,针对患者进行放疗计划平面剂量分布验证,选择不同评价标准（3 mm/3%、2 mm/2%和1 mm/1%）,分析在不同评价标准下Gamma通过率的变化。根据评价标准,分析在不同输出分辨率（0.6 mm、1 mm、2 mm、3 mm、4 mm、5 mm、6 mm）下Gamma通过率的变化情况。选取不同射野（30 cm×30 cm与40 cm×40 cm）,分析Gamma通过率的变化。结果:以3 mm/3%为标准的Gamma通过率高于2 mm/2%、1 mm/1%,且2 mm/2%的Gamma通过率高于1 mm/1%,差异有统计学意义（P＜0.05）。当输出分辨率为3 mm时,无论采用何种评价方式,通过率均有明显下降,其中输出分辨率为4 mm、5 mm、6 mm时的Gamma通过率低于0.6 mm、1 mm、2 mm,差异有统计学意义（P＜0.05）。无论选择何种输出分辨率,3 mm/3%的Gamma通过率始终高于2 mm/2%、1 mm/1%,且2 mm/2%的通过率始终高于1 mm/1%,差异有统计学意义（P＜0.05）。30 cm×30 cm射野下的Gamma通过率高于40 cm×40 cm,差异有统计学意义（P＜0.05）。结论:随着输出分辨率越高,Gamma通过率越低,以3 mm/3%作为评价标准时通过率最高,与40 cm×40 cm射野相比,30 cm×30 cm射野下的通过率更高。     

GZ-2002急性淋巴细胞白血病化疗方案治疗非高危儿童急性淋巴细胞白血病多中心协作临床研究

目的探讨多中心合作开展小儿急性淋巴细胞白血病(ALL)化疗的可能性和提高ALL治愈率的新策略。方法协作组由广州市7家大型医院组成,各单位指定负责人1人,并设立专职资料管理员1人。协作组邀请香港中文大学威尔斯亲王医院为顾问单位。各单位对符合入选标准的新诊断标准危险型(SR)和中度危险型(IR)ALL患儿均采用GZ-2002 ALL化疗方案,所有病例按细胞形态学、免疫学和细胞遗传学分型。根据发病时的年龄、外周血白细胞、第8天的泼尼松反应、t(9:22)或t(4;11)、BCR/ABL和MLL/AF4融合基因,以及化疗第33天是否完全缓解确定临床类型。GZ-2002方案以BFM2002方案为基础,总疗程共104周,由诱导期、巩固期、再诱导期和维持期组成。结果 2002年10月~2009年6月,协作组共收治ALL患儿617例,随访至2009年10月31日,中位随访时间44.5个月(范围:4~84个月)。按协作组诊断标准,把儿童ALL分为SR、IR和高危型(HR)。入组采用GZ-2002 ALL化疗方案的SR和IR患儿共446例,男227例,女169例;年龄1~14岁(中位年龄6岁)。诱导期的总完全缓解率为99.8%(445/446)。SR组3年和5年无事件生存率(EFS)分别为(90.5±5.0)%和(82.0±4.0)%。IR组3年和5年EFS分别为(88.0±6.0)%和(78.0±5.0)%,两组差异均有显著性意义(P<0.05)。至随访终止日,共随访到回复病例413例,占总例数的92.6%。可随访例数中无事件生存者339例(82.1%),其中停药无病生存者267例(78.8%),进入维持阶段72例(21.2%)。有"事件"者78例(18.9%),其中复发47例(11.4%),非复发死亡20例(4.8%)。远期毒副作用8例(1.9%),第2肿瘤3例(0.7%);复发者已死亡24例(含6例复发后放弃),带病存活23例。死亡的中位时间为治疗后7.9个月(1.5~23个月)。失访33例,其中停药后失访5例,维持期间因出国、搬家、原联络地址变更和回原籍(广东省以外)等共28例。结论 GZ-2002 ALL化疗方案的疗效满意,广州地区多中心协作的模式是成功的,这种协作模式对推动我国开展更大规模的协作提供了宝贵的经验。     

AN EPIDEMIC OF PLEURISY AMONGST MILITARY RECRUITS

An epidemic amongst recruits who presented with acute viral exudative pleural effusion with lymphocytic pleocytosis is analysed. Histologic and bacteriologic proof of tuberculosis was lacking in majority. Most of them recovered without pleural thickening. Overcrowding, inadequate clothing protection, stress and strain of vigorous recruit training could be important precipitating factors. None reported with parenchymal tuberculosis in two year follow up.KEY WORDS: Pleural effussion, Viral     

纳米级与微米级珍珠粉对大鼠深Ⅱ度烫伤的药效学评价

目的：比较纳米级与微米级珍珠粉对大鼠烫伤皮肤的愈合效果。方法：建立大鼠深Ⅱ度烫伤模型;分别以纳米级珍珠粉高低剂量（30 m g/d,10 m g/d）、微米级珍珠粉高低剂量（30 m g/d,10 m g/d）以及阳性和阴性对照共6组进行对比治疗,测量第3天,第7天和第14天伤痕面积以及各组的痊愈时间;并采用配对t检验法对数据进行统计分析。结果：纳米级珍珠粉对烫伤皮肤的治疗效果要显著优于相应的微米级珍珠粉;纳米级高剂量组（30 m g/d）效果最好,与阳性药物相当;纳米级低剂量组（10 m g/d）的疗效与微米级高剂量组（30 m g/d）相当。结论：珍珠粉纳米化后能显著提高其对烫伤的治疗效果。     

内科胸腔镜在合并胸腔积液肺癌患者分期诊断中的价值

目的 探讨可弯曲内科胸腔镜在合并胸腔积液的肺癌患者临床分期中的应用价值.方法 采用Olympus LTF-240型可弯曲内科电子胸腔镜,对病理已确诊的合并中小量胸腔积液的24例肺癌患者,在分期诊断中行内科胸腔镜检查.24例包括腺癌15例、鳞癌7例、小细胞肺癌2例.结果 内科胸腔镜下可见胸膜病变17例,包括结节13例、扁平隆起2例、胸膜弥漫性充血2例,经内科胸腔镜检查证实为胸膜转移12例,排除胸膜转移12例.15例腺癌有11例确诊为胸膜转移,7例鳞癌1例确诊胸膜转移,2例小细胞肺癌未发现胸膜转移.24例胸腔镜检查均未见严重并发症.结论 内科胸腔镜检查能提高肺癌分期诊断的准确性且安全微创,建议在合并胸腔积液的肺癌患者分期诊断中积极行内科胸腔镜检查.