Background Anaphylactic reactions during anesthesia and operation are common and life threatening.Follow-up investigation is necessary for avoiding potential re-exposure of the patients to the offending drugs.The purp...Background Anaphylactic reactions during anesthesia and operation are common and life threatening.Follow-up investigation is necessary for avoiding potential re-exposure of the patients to the offending drugs.The purpose of this study was to assess cellular allergen stimulation test （CAST） as a diagnostic instrument in immunoglobulin E （IgE）-and non-lgE-mediated anaphylactic reactions.Methods This study included 25 patients who developed perioperative anaphylactic reactions and 10 subjects that tolerated anesthetics and other drugs during perioperative period from September 2009 to October 2013 in Peking Union Medical College Hospital.We performed skin tests and flow cytometric analysis of basophil activation-based CAST in all subjects.Results Of the 25 patients,17 had IgE-mediated anaphylactic reactions （causative agent identified by skin tests） and 8 had non-lgE-mediated anaphylactic reactions （negative skin tests）.CAST showed a sensitivity of 42.9％,specificity of 90％,and negative predictive value of 80.6％ for neuromuscular blocking agents.Conclusions CAST may be useful for the diagnosis of anaphylactic reactions during perioperative period.Our findings call for further investigation to increase the sensitivity of the test.展开更多
Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper li...Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-r TMS and i OT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient＇s Trail-Making Test part B（TMT-B） performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-r TMS to the contralesional hemisphere and 2 sessions of i OT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-r TMS to the contralesional hemisphere combined with i OT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.展开更多
A 79-year-old man was diagnosed as stage IV colon cancer and treated with a modified FOLFOX6 （mFOLFOX6） regimen.On the 12th cycle,we observed erythema and dyspnea.Radiographs showed ground grass opacities.Blood test...A 79-year-old man was diagnosed as stage IV colon cancer and treated with a modified FOLFOX6 （mFOLFOX6） regimen.On the 12th cycle,we observed erythema and dyspnea.Radiographs showed ground grass opacities.Blood tests showed elevated levels of eosinophils and immunoglobulin E.We diagnosed this finding as response to drug allergy and administered high-dose methylprednisolone.The treatment was successful and he was discharged.The drug lymphocyte stimulating test against oxaliplatin was positive,indicating a type I and IV allergic reaction due to oxaliplatin.Regimens including oxaliplatin must be carefully monitored and frequent blood tests and chest radiographs are needed.展开更多
文摘Background Anaphylactic reactions during anesthesia and operation are common and life threatening.Follow-up investigation is necessary for avoiding potential re-exposure of the patients to the offending drugs.The purpose of this study was to assess cellular allergen stimulation test （CAST） as a diagnostic instrument in immunoglobulin E （IgE）-and non-lgE-mediated anaphylactic reactions.Methods This study included 25 patients who developed perioperative anaphylactic reactions and 10 subjects that tolerated anesthetics and other drugs during perioperative period from September 2009 to October 2013 in Peking Union Medical College Hospital.We performed skin tests and flow cytometric analysis of basophil activation-based CAST in all subjects.Results Of the 25 patients,17 had IgE-mediated anaphylactic reactions （causative agent identified by skin tests） and 8 had non-lgE-mediated anaphylactic reactions （negative skin tests）.CAST showed a sensitivity of 42.9％,specificity of 90％,and negative predictive value of 80.6％ for neuromuscular blocking agents.Conclusions CAST may be useful for the diagnosis of anaphylactic reactions during perioperative period.Our findings call for further investigation to increase the sensitivity of the test.
文摘Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-r TMS and i OT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient＇s Trail-Making Test part B（TMT-B） performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-r TMS to the contralesional hemisphere and 2 sessions of i OT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-r TMS to the contralesional hemisphere combined with i OT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.
文摘A 79-year-old man was diagnosed as stage IV colon cancer and treated with a modified FOLFOX6 （mFOLFOX6） regimen.On the 12th cycle,we observed erythema and dyspnea.Radiographs showed ground grass opacities.Blood tests showed elevated levels of eosinophils and immunoglobulin E.We diagnosed this finding as response to drug allergy and administered high-dose methylprednisolone.The treatment was successful and he was discharged.The drug lymphocyte stimulating test against oxaliplatin was positive,indicating a type I and IV allergic reaction due to oxaliplatin.Regimens including oxaliplatin must be carefully monitored and frequent blood tests and chest radiographs are needed.
