Objective To analyze the correlation between HLA-A and B genotypes and maculopapular exanthema (MPE) caused by Carbamazepine (CBZ) and Oxcarbazepine (OXC), and to explore the genetic risk factors of MPE. Methods Patients with MPE (rash group) and patients without MPE (non-rash group) after taking CBZ or OXC were retrospectively collected from January 2016 to October 2021 in the Second Affiliated Hospital of Guangzhou Medical University. DNA was extracted from peripheral blood. HLA-A and HLA-B alleles were sequenced by high resolution sequencing, and a case-control study was conducted to analysis the correlations between MPE and HLA genotypes. Results A total of 100 patients with CBZ-MPE, 100 patients with CBZ-tolerant, 50 patients with OXC-MPE, and 50 patients with OXC-tolerant were collected. There was no significant difference in age and sex between CBZ, OXC rash groups and non-rash groups The average latency of CBZ-rash group was (11.31±11.00) days and their average dosage was (348.46±174.10) mg; the average latency of OXC-rash group was (11.67±10.34) days and their average dosage was (433.52±209.22) mg [equivalent to CBZ (289.01±139.48 mg)], showing no significant difference in latency and dosage between CBZ and OXC (P>0.05). The positive rates of HLA-A*24:02 and A*30:01 in CBZ-rash group were 28% and 6%, respectively, which were significantly higher than those in CBZ-non rash group (16% and 0%, both P=0.04). The positive rate of HLA-B*40:01 in CBZ-rash group was 18%, which was significantly lower than that in CBZ-non rash group (40%, P<0.001). No association between HLA-A or B genotype and OXC-rash was found yet. When pooled, it was still found that the positive rates of HLA-A*24:02 and A*30:01 in the rash group were higher than those in the non-rash group, while the positive rate of HLA-B*40:01 in the rash group was lower than that in the non-rash group, and the difference was statistically significant (P<0.05). Conclusions HLA-A*24:02 and A*30:01 were associated with MPE caused by CBZ, and may be common risk factors for aromatic antiepileptic drugs.
Outcome-based education (OBE) emphasizes student learning outcomes as the core, utilizing a backward design approach to construct the curriculum. In teaching practice based on OBE, teachers need to develop a blueprint in advance that is closely aligned with the content of the teaching, aiming to promote deep learning and ensure that students can fully demonstrate their learning outcomes. Electroencephalogram (EEG) is a widely used technology in the field of neuroscience, and the special EEG changes convey a variety of information, which is crucial to the study of diseases. However, due to its specialization and learning difficulty, EEG teaching has been facing many challenges. Under the guidance of OBE concept, traditional knowledge lecture and problem-based learning (PBL) are organically integrated, combined with case analysis and flipped classroom teaching mode, which are applied in EEG teaching practice, in order to obtain more ideal teaching effect.
Objective To study the therapeutic effect of combining vacuum seal ing drainage (VSD) with gluteus maximus myocutaneous flap on the repair of soft tissue defect caused by the resection of sacral tumors. Methods From June2007 to June 2008, 6 patients with skin and soft tissue necrosis in the sacrococcygeal region, deep infection, and formation of cavity at 3-6 weeks after sacral tumors resection were treated. There were 4 males and 2 females aged 17-51 years old. The size of skin and soft tissue defects ranged from 15 cm × 11 cm × 6 cm to 20 cm × 18 cm × 7 cm. Every patient underwent VSD treatment for 7-10 days, and the recombinant bovine bFGF was injected into the wound intermittently for 7-14 days (250-300 U/ cm2 once, twice daily). The wound was repaired by either the gluteus maximus myocutaneous flap (5 cases) or the lumbar-gluteus flap (1 case), and those flaps were 9 cm × 9 cm-20 cm × 18 cm in size. The donor site were sutured or repaired with spl itthickness skin graft. Results All the flaps survived uneventfully. The wound healed by first intention in 5 cases, but 1 case suffered from fat l iquefaction 2 weeks after operation and healed after drainage and dressing change. All the donor sites healed by first intention, and all the skin grafts survived uneventfully. All the patients were followed up for 6-10 months, there was no relapse of sacral tumor, and the flaps showed no obvious swell ing with good color and elasticity. Conclusion With fewer compl ications, the combination of VSD and gluteus maximus myocutaneous flap is a safe and rel iable operative method for repairing the skin and soft tissue defects caused by the resection of sacral tumors.
