Clinical observation on the treatment of oral lichen planus with total glucosides of paeony capsule combined with corticosteroids

IntroductionOral lichen planus (OLP) is a relatively common, chronic immune-mediated disease. The main treatment for OLP has been the administration of topical or systemic corticosteroids, but side effects have limited their use. We aimed to assess the effect and adverse reaction of total glucosides of paeony capsule (TGPC) in combination with corticosteroids for the treatment of OLP.MethodsEighty one patients with a confirmed clinical and histopathologic diagnosis of OLP (44 reticular OLP [ROLP] patients, 37 erythematous/erosive OLP [EOLP] patients) were enrolled. Patients were treated with topical or systemic corticosteroids, with or without 1200 mg TGPC in the ROLP and EOLP groups, respectively. Patients were followed for 6 months. The pain and severity of the lesions were recorded at the initial visit and monthly thereafter during the follow-up period.ResultsSeventy three of 81 patients completed the scheduled treatment period. In the ROLP patient group, combined treatment significantly reduced the visual analogue scale (VAS) at months 3, 5, and 6. The clinical signs (CS) of ROLP patients worsened during the follow-up period in control group. However, CS in the combined treatment group remained largely unchanged at months 4–6. In the EOLP patient group, the VAS decreased almost equally in patients with and without combined treatment at months 1–2, but continued to significantly decrease in the combined treatment group in months 4–6. The CS of the combined treatment group decreased gradually over time in the study period, with significantly lower scores in the treatment versus control group (which decreased slightly in the first three months, then remained almost unchanged during the following visits). The effective rates of combined treatment were statistically higher versus control groups both in ROLP and EOLP patients.ConclusionsTGPC is a safe and effective drug for OLP with rare side effects. Combined treatment of TGPC with corticosteroids shows a definite therapeutic effect. More than four months of medical treatment of TGPC is recommended to achieve the full effect.     

Genomic and Transcriptomic Characterization of Natural Killer T Cell Lymphoma

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新型冠状病毒肺炎期间骨盆髋臼骨折诊疗专家共识

自2019年12月以来,新型冠状病毒(2019-nCoV)感染的肺炎(COVID-19)疫情暴发并向全国蔓延。相较于严重急性呼吸综合征(SARS)冠状病毒,2019-nCoV致死率更低,但却具有更高的传染性和致病力。截至2020年2月22日24时,累计报告确诊病例76936例(武汉36174例)[1];截至2月11日,全国医务人员感染3019例[2],远远超过了"非典"疫情感染人数。骨盆、髋臼骨折是创伤救治中最为复杂的病情之一,其发生率约占全身骨折的3%[3]。骨盆、髋臼骨折常发生于高能量损伤,容易合并大出血、重要脏器损伤等严重情况,病死率一直居高不下[4]。病毒流行为疫区骨盆、髋臼骨折院前急救、急诊诊疗、手术策略、麻醉和围手术期管理等医务工作带来了巨大挑战。在疫情流行期间,为了降低骨盆、髋臼骨折救治过程中患者之间、患者与医务人员之间、医务人员相互之间交叉感染的风险,提高骨折预后水平,需要通过多学科协作,统筹传染病和骨盆、髋臼骨折的诊疗方案,制定严密的诊疗计划,降低疾病的致残率和致死率。为响应党中央号召,科学战"疫",坚决打赢这场疫情防控的人民战争、总体战、阻击战,根据《新型冠状病毒感染的肺炎诊疗方案(试行第六版)》,结合肺炎防治和创伤救治相关诊疗指南[5,6,7,8,9,10],特制定此诊疗专家共识,以规范COVID-19疫情期间骨盆、髋臼骨折的诊疗,提高治愈率,降低交叉感染的风险。     

The Chinese consensus for surgical treatment of traumatic rib fractures 2021 (C-STTRF 2021)

Rib fracture is the most common injury in chest trauma. Most of patients with rib fractures were treated conservatively, but up to 50% of patients, especially those with combined injury such as flail chest, presented chronic pain or chest wall deformities, and more than 30% had long-term disabilities, unable to retain a full-time job. In the past two decades, surgery for rib fractures has achieving good outcomes. However, in clinic, there are still some problems including inconsistency in surgical indications and quality control in medical services. Before the year of 2018, there were 3 guidelines on the management of regional traumatic rib fractures were published at home and abroad, focusing on the guidance of the overall treatment decisions and plans; another clinical guideline about the surgical treatment of rib fractures lacks recent related progress in surgical treatment of rib fractures. The Chinese Society of Traumatology, Chinese Medical Association, and the Chinese College of Trauma Surgeons, Chinese Medical Doctor Association organized experts from cardiothoracic surgery, trauma surgery, acute care surgery, orthopedics and other disciplines to participate together, following the principle of evidence-based medicine and in line with the scientific nature and practicality, formulated the Chinese consensus for surgical treatment of traumatic rib fractures (STTRF 2021). This expert consensus put forward some clear, applicable, and graded recommendations from seven aspects: preoperative imaging evaluation, surgical indications, timing of surgery, surgical methods, rib fracture sites for surgical fixation, internal fixation method and material selection, treatment of combined injuries in rib fractures, in order to provide guidance and reference for surgical treatment of traumatic rib fractures.     

Hormone Receptor and Human Epidermal Growth Factor Receptor 2 Detection in Invasive Breast Carcinoma: A Retrospective Study of 12,467 Patients From 19 Chinese Representative Clinical Centers

IntroductionWe evaluated the current status of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) detection in invasive breast carcinoma (IBC) in various laboratories across China.Materials and MethodsThe Breast Pathology Study Group of the Chinese Society of Pathologists collected HR and HER2 data from 12,467 IBC cases from 19 representative clinical centers in China. The data from every center were compared with the pooled data from the other centers.ResultsThe assessment of HR status showed that the overall positive estrogen receptor (ER) and progesterone receptor (PR) rates were 71.7% and 63.7% (range, 60.9%-87.9% and 43.9%-84.8%), respectively. The ER results in 3 centers and the PR results in 6 centers were outside the 99.5% confidence interval and were considered to be outliers (P < .0005). Of the 12,467 cases, 62.4% were ER⁺/PR⁺, 9.3% were ER⁺/PR⁻, 1.3% were ER⁻/PR⁺, and 27.0% were ER⁻/PR⁻. The assessment of HER2 status showed that the overall positive rate of HER2 (with a definition of immunohistochemistry [IHC] 3+ or IHC2+/ in situ hybridization-positive) was 24.7% (range, 13.7%-35.7%) in each center. Three centers were outside the 99.5% confidence interval and were considered to be outliers (P < .0005). The proportion of HER2 IHC3+ was 21.1%. The positive rates of HER2 gene amplification in IHC 0/1+, 2+, 3+ cases were 2.0%, 17.6%, and 85.9%, respectively.ConclusionsAs the largest study of HR and HER2 status in Chinese patients with IBC, the data from the present study have indicated that the overall rates of HR and HER2 were comparable to those reported in previous studies. However, the rates varied among the laboratories. Individual centers had not met the target values, and they need to improve the detection.