ObjectiveTo evaluate the efficacy and safety of dupilumab in the treatment of moderate-to-severe asthma. MethodsA retrospective study was conducted among patients with moderate-to-severe asthma who were treated with dupilumab and inhaled corticosteroids (ICS) combined with long acting beta-agonist (LABA) in Department of Respiratory, Beijing Chao-yang Hospital from May, 2021 to April, 2022. Paired t-test or Mann-Whitney U test was applied to compare the Asthma Control Test (ACT) scores, number of acute exacerbations per year, type 2 inflammatory biomarkers, blood total IgE and results of pulmonary function tests, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1 as percentage of predicted (FEV1%pred), FEV1/FVC, peak expiratory flow (PEF), maximal expiratory flows (MEF) at 75% (MEF75), 50% (MEF50) and 25% (MEF25) of the vital capacity PEF, and maximal mid-expiratory flow (MMEF) or FEF25%-75%, at the end of follow-up with those before treatment. Adverse reactions were recorded during the treatment. ResultsA total of 47 patients with moderate-to-severe asthma were included in the study, among them 17 and 30 received treatment with dupilumab or ICS/LABA. At the time of 12 months after treatment with dupilumab, the patients' ACT score and pulmonary function tests were significantly increased compared with those at the baseline. In contrast, patients' fractional exhaled nitric oxide (FeNO), blood total IgE, blood basophil counts and annual acute exacerbations were significantly decreased in comparison with those at the baseline. The doses of oral corticosteroids added by 7 patients at the baseline was gradually reduced and finally discontinued after treatment of dupilumab. There were 4, 2, 1 and 1 patients developed injection site reaction, pruritus, erythema and fatigue, respectively, which were mild and recovered without treatment. There was no serious adverse reaction observed, and only 1 case developed herpes zoster which was recovered after treatment. ConclusionDupilumab shows marked efficacy in the treatment of moderate-to-severe asthma with favorable safety.
Objective To investigate the effectiveness of single Taylor external fixator combined with biplanar osteotomy on correction of tibial multiplanar deformities. Methods Between October 2016 and December 2021, 11 patients with tibial multiplanar deformities (20 sides) were treated with single Taylor external fixator and biplanar osteotomy. Of them, 4 were male and 7 were female; the average age ranged from 13 to 33 years (mean, 21.9 years). Diagnosis included rickets severe genu varum deformity (7 cases, 14 sides), rickets severe genu valgum deformity (2 cases, 4 sides), multiple osteochondromatosis calf deformity (1 case, 1 side), neurofibromatosis medial lower leg anterior arch deformity with short of leg (1 case, 1 side). After fibular osteotomy and tibial multiplanar osteotomy, a Taylor external fixator was installed. After operation, the deformities were corrected successively and fixed completely. The osteotomy healed, then the external fixator was removed. Before operation and at 12 months after operation, the full-length X-ray films were taken. The leg-length discrepancy, medial proximal tibial angle (MPTA), lateral distal tibial angle (LDTA), posterior proximal tibial angle (PPTA), anterior distal tibial angle (ADTA), and tibial rotation angle were measured. The degree of lower limb deformity was scored with reference to a customized tibial mechanical axis scoring table. Results Osteotomy was successfully completed without neurovascular injury and other complications. The external fixator was adjusted for 28-46 days, with an average of 37 days, and the external fixator was worn for 136-292 days, with an average of 169 days. Mild needle infection during the fixation period occurred in 3 sides, refracture at the distal tibial osteotomy in 1 side after removing the external fixator, and nonunion of the distal fibular osteotomy in 1 side. All patients were followed up 369-397 days (mean, 375 days). At 12 months after operation, the lower limb discrepancy decreased, but there was no significant difference (P>0.05). MPTA, LDTA, PPTA, ADTA, and tibial rotation angle improved, and the differences in LDTA, ADTA, and tibial rotation angle were significant (P<0.05). The score of lower limb deformity was significantly higher than that before operation (P<0.05), and the results were excellent in 9 sides, good in 8 sides, fair in 3 sides, with the excellent and good rate of 85%. ConclusionSingle Taylor external fixator combined with biplanar osteotomy is effective in the correction of tibial multiplanar deformities.