Trends in Specific Immunotherapy for Allergic Rhinitis: A Survey of Chinese ENT Specialists

PURPOSE: Specific immunotherapy (SIT) is a suitable but uncommon treatment option for allergic rhinitis (AR) in China. The current understanding and attitude of Chinese ENT (ear, nose, and throat) specialists in regards to SIT is unclear. This study investigates current trends in the awareness and application status of SIT among Chinese ENT specialists. METHODS: We performed a nationwide, cross-sectional survey with a specially designed questionnaire given to 800 ENT specialists in China. A member of the trained research group conducted face-to-face interviews with each respondent. RESULTS: Most of the respondents considered AR (96.0%) and allergic asthma (96.0%) the most suitable indications for SIT. Of all respondents, 77.0% recommended the application of SIT as early as possible; in addition, SIT was considered 'relatively controllable and safe' by most respondents (80.6%). The highest allergen-positive rate in AR was associated with house dust mite (47.7%) and obvious differences existed among geographical regions. Conventional subcutaneous immunotherapy was the most highly recommended treatment option (96.2%). 'The high cost of SIT' (86.6%) and 'lack of patient knowledge of SIT' (85.2%) were probably the main reasons for the lower clinical use of SIT in China. CONCLUSIONS: Most cases showed that the opinions of Chinese ENT specialists appeared to be in agreement with recent SIT progress and international guidelines; however, many areas still need to enhance the standardization and use of SIT in China. Clinical guidelines for SIT require improvement; in addition, Chinese ENT specialists need continuing medical education on SIT.

Establishment of an albumin and cytokeratin 19 genetically-modified embryonic stem cell line and evaluation of its hepatoblast differentiation capacities / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To establish a gene-modified embryonic stem (ES; E14.1-2) cell line with hepatoblast differentiation reporter genes, albumin (ALB) and cytokeratin 19 (CK19), labeled to facilitate study of their potential applicability as differentiated hepatoblasts.</p><p><b>METHODS</b>Two expression vectors were constructed, one with the ALB promotor driving the enhanced green fluorescent protein (EGFP) and anti-neomycin genes (pAlb-EGFP), and the other with the CK19 promotor driving the red fluorescence protein and anti-hygromycin genes (pCK19-hCD25-IRES-tdTOMATO). The linearized vectors were electroporated into the E14.1 line, and double reporter genes-modified ES cells (E14.1-2) were selected by neomycin and hygromycin. E14.1-2 hepatoblast differentiation was induced by exposure to growth factors (BMP4 and bFGF) and evidenced by embryoid body formation. Fluorescence-activated cell sorting (FACS) and reverse transcription-polymerase chain reaction (RT-PCR) were used to confirm whether differentiated cells were hepatoblast-like and to quantify the differentiation efficiency.</p><p><b>RESULTS</b>The pAlb-EGFP and pCK19-hCD25-IRES-tdTOMATO vectors were shown to specifically activate ALB and CK19 expression. The E14.1-2 cell line with labeled ALB and CK19 was established, and shown to have pluripotency by RT-PCR detection of pluripotent markers' expression, namely Oct4 and SSEA-1. After 22 days of induction, 21.27% of the differentiated hepatoblasts were detected by FACS as positive for ALB and CK19 expression.</p><p><b>CONCLUSIONS</b>A gene-modified ES cell line was generated with hepatocyte differentiation reporter genes ALB and CK19 labeled. The differentiation of the resultant E14.1-2 line was technically simple to qualify and quantify, and will likely aid future studies of hepatoblast characteristics.</p>

Impact of fish oil enriched total parenteral nutrition on elderly patients after colorectal cancer surgery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Polyunsaturated omega-3 fatty acids may beneficially influence healing processes and patient outcomes. The aim of this research was to study the clinical efficacy of fish oil enriched total parenteral nutrition in elderly patients after colorectal cancer surgery.</p><p><b>METHODS</b>Fifty-seven elderly patients with colorectal cancer were enrolled in this prospective, randomized, double-blind, controlled clinical trial. All patients received isocaloric and isonitrogenous total parenteral nutrition by continuous infusion (20 - 24 hours per day) for seven days after surgery. The control group (n = 28) received 1.2 g/kg soybean oil per day, whereas the treatment group (n = 29) received 0.2 g/kg fish oil and 1.0 g/kg soybean oil per day. Blood samples were taken pre-operatively, and at days one and eight after the operation. The plasma levels of CD4, CD8, CD4/CD8, interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured. Clinical outcomes were then analysed.</p><p><b>RESULTS</b>Patient characteristics were comparable between the two groups. At day eight post-surgery, IL-6, TNF-α and CD8 titres were lower in the treatment group when compared to the control group; these results reached statistical significance. In the treatment group, there were fewer infectious complications and incidences of systemic inflammatory response syndrome (SIRS), and shorter lengths of hospital stay were observed. The total cost of medical care was comparable for the two groups. No serious adverse events occurred in either group.</p><p><b>CONCLUSIONS</b>Fish oil 0.2 g/kg per day administrated to elderly patients after colorectal surgery was safe and may shorten the length of hospital stay and improve clinical outcomes.</p>

A multicenter, phase III trial of hemocoagulase Agkistrodon: hemostasis, coagulation, and safety in patients undergoing abdominal surgery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hemocoagulase Agkistrodon for injection is a single component thrombin which has passed phases I and II clinical trials. The purpose of this phase III clinical trial was to evaluate the effect of Hemocoagulase Agkistrodon on hemostasis and coagulation in abdominal skin and subcutaneous incisions and to assess the safety of this agent in surgical patients.</p><p><b>METHODS</b>This is a phase III, prospective, randomized, double-blind, and controlled multicenter clinical trial including 432 consecutive patients randomized into either a study group (injected with hemocoagulase Agkistrodon at 2 U, n = 324) or a control group (injected with hemocoagulase Atrox, n = 108). The hemostatic time, hemorrhagic volume, hemorrhagic volume per unit area, blood coagulation, and adverse events were measured and compared between the two groups.</p><p><b>RESULTS</b>The mean hemostatic time in the study group was (36.8 +/- 18.7) seconds; the hemorrhagic volume was (3.77 +/- 3.93) g; and the hemorrhagic volume per unit area was (0.091 +/- 0.125) g/cm(2). In the control group, the corresponding values were (38.1 +/- 19.7) seconds, (4.00 +/- 4.75) g, and (0.095 +/- 0.101) g/cm(2), respectively. No significant difference in values existed between the two groups (P > 0.05). Blood coagulation results and hepatic and renal function were also similar between the two groups. Adverse events were reported in two cases, but were deemed non-drug-related.</p><p><b>CONCLUSIONS</b>Hemocoagulase Agkistrodon has good hemostatic and coagulative function and is safe for the use of arresting capillary hemorrhage that occurs while incising the abdomen during surgery.</p>

FTY720-induced lymphocyte apoptosis inhibits acute graft versus host disease in rat small bowel transplantation / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect and mechanism of FTY720 on acute graft versus host disease (GVHD) in rat small bowel transplantation (SBTx).</p><p><b>METHODS</b>Heterotopic SBTx was performed using a parent (WF)-into-F1 (WFxACI) rat combination. Recipient rats were divided into experimental group (n=6) and control group (n=6). Rats in the experimental group were administered with FTY720 at 0.5 mg/kg for 14 days. Lymphocyte apoptosis in the liver and the mucosa of intestine and graft was detected by TUNEL and flow cytometry 15 days after transplantation. Recipient survival and lymphocyte apoptosis were compared between the two groups.</p><p><b>RESULTS</b>Recipients in the control group died of GVHD after a mean survival time of (16+/-2.1) days. FTY720-treated recipients had a significantly longer survival (>100 days). After administration of FTY720, the percentage of apoptotic lymphocytes was significantly increased in the graft as compared to that in the control group by flow cytometry. The ratio of apoptotic lymphocyte in the liver and graft was also significantly higher in the experimental group by TUNEL.</p><p><b>CONCLUSION</b>FTY720 effectively induces the lymphocyte apoptosis, inhibits the lesion of target tissues by GVHD, and prolongs the recipient survival.</p>

Current state of diagnosis and treatment of allergic rhinitis in China / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the understanding among otolaryngologists and perspectives on the diagnosis and management of allergic rhinitis in major cities in China.</p><p><b>METHODS</b>A survey among otolaryngologists in mainland China was carried out through questionnaire, including the medical history, diagnosis and pharmacotherapy.</p><p><b>RESULTS</b>The survey was conducted in 508 otolaryngologists. In general otolaryngology head and neck surgery clinic, the patients with allergic rhinitis was about 19% +/- 14%, which was of 35% +/- 17% in rhinological clinic. Most of the otolaryngologists (61% +/- 29%) diagnosed AR based on medical history and nasal examination. Only 35% +/- 28% of the otolaryngologists used skin prick test or specific IgE serum test. 70% +/- 27% of the patients with AR were offered nasal steroids, 49% +/- 32% and 36% +/- 28% of the patients were offered oral or nasal antihistamines respectively. Only 24% +/- 17% of patients realized the importance of follow-up.</p><p><b>CONCLUSIONS</b>Allergic rhinitis is a core component in the specialty of otolaryngology head and neck surgery. The diagnosis and management of allergic rhinitis is sub-optimal. Chinese otolaryngologists need continuous education in aspects of diagnosis and management of allergic rhinitis.</p>

The XbaI and PvuII gene polymorphisms of the estrogen receptor alpha gene in Chinese women with breast cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the associations of the XbaI and PvuII gene polymorphisms in estrogen receptor alpha (ER alpha) gene and breast cancer risk.</p><p><b>METHODS</b>Using the method of restrictive fragment length polymorphism, the XbaI and PvuII genotypes of ER alpha gene were examined in 138 female breast cancer patients and 140 healthy control subjects that age and sex matched. Analyses stratified by menopausal status were conducted to check the associations of the XbaI and PvuII gene polymorphisms of ER alpha gene and breast cancer risk.</p><p><b>RESULTS</b>The frequencies of the XbaI and PvuII alleles of ER alpha gene were 28.9% for XbaI X allele and 39.6% for P PvuII allele, respectively, in healthy Han Chinese. The frequencies of XX and PP genotypes were 4.3% and 15.0%, respectively. The frequencies of Xx genotype and carrier with X allele (XX + Xx) in breast cancer patients were 34.8% and 39.1%, respectively, significantly lower than that in controls with 49.3% and 53.6%, respectively (P = 0.013 and P = 0.016, respectively). The odds ratio (OR) for heterozygous Xx and carriers with X allele (XX + Xx) were 0.538 (95% CI: 0.330 - 0.879) and 0.557 (95% CI: 0.346 - 0.897), respectively, decreased the breast cancer risk compared with the homozygous xx genotype. The decreases in the OR showed to be more significantly in the postmenopausal women, OR were 0.366 (95% CI: 0.161 - 0.834) and 0.371 (95% CI: 0.167 - 0.823), respectively. No significant difference was showed in the PvuII genotype distribution between patients and controls.</p><p><b>CONCLUSIONS</b>The XbaI gene polymorphism of ER alpha gene was associated with breast cancer risk, more significantly in postmenopausal women. The XbaI X allele could decrease the risk of breast cancer. No apparent effect of the PvuII gene polymorphisms of ER alpha gene was identified.</p>

Differential gene expression of liver carcinoma cell after transfection of by ARL-1 with microarray / 中华外科杂志

<p><b>OBJECTIVE</b>To study the difference of the gene expression profile and to identify the different expression after transfection of the ARL-1 gene.</p><p><b>METHODS</b>The cDNA probes were synthesized from total RNA of study group and control group, which was differentially hybridized to cDNA chips and confirmed by a gene specific semiquantitative reverse transcription polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>Six kinds of gene expression were increased and 9 kinds of gene expression were decreased. The findings were correlated with protein metabolism, signal pathway, metastasis, and drug resistance.</p><p><b>CONCLUSIONS</b>cDNA chips showed that gene expression profile of liver carcinoma cell was changed after transfection of the ARL-1 gene. It is a useful method in understanding the mechanism of drug resistance.</p>

Alternation and significance of CD4(+)CD45RA(+) and CD4(+)CD45RO(+) T cells in peripheral blood of colorectal cancer patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the alternation and significance of CD4(+)CD45RA(+) T cells and CD4(+)CD45RO(+) T cells in peripheral blood of colorectal cancer patients.</p><p><b>METHODS</b>The expression of CD4(+) T cells, CD4(+)CD45RA(+) T cells and CD4(+)CD45RO(+) T cells in peripheral blood of 60 colorectal cancer patients were detected with flow cytometry pre-operatively and 1, 3 months post-operatively, compared with those of 10 healthy persons.</p><p><b>RESULTS</b>CD4(+) T cells expression of colorectal cancer patients was the same as the healthy persons. The proportion of CD4(+)CD45RO(+) T cells of colorectal cancer patients was higher, which descended post-operatively, especially in Dukes A and B patients, while CD4(+)CD45RA(+) T cells showed the opposite findings.</p><p><b>CONCLUSION</b>CD4(+)CD45RA(+) T cells and CD4(+)CD45RO(+) T cells, playing an important immune effect in colorectal cancer patients, is closely related to stage and prognosis.</p>