A multi-center observation of the therapeutic efficacy of Bencycloquidium bromide in the treatment of seasonal allergic rhinitis with predominant symptoms of rhinorrhea / 临床耳鼻咽喉头颈外科杂志

Objective:To observe the efficacy and safety of the M receptor antagonist Bencycloquidium bromide nasal spray in treatment of seasonal allergic rhinitis with runny nose as the main symptom. Methods:From August 2021 to September 2021, 134 patients with seasonal allergic rhinitis were enrolled in the otolaryngology Outpatient Department of Peking University Third Hospital, First Affiliated Hospital of Harbin Medical University and China-Japanese Friendship Hospital of Jilin University, including 71 males and 63 females, with a median age of 38 years. TNSS score and visual analogue scale（VAS） of total nasal symptoms were observed during 2 weeks of treatment with Bencycloquidium bromide nasal spray. Results:TNSS score decreased from （8.89±3.31） on day 0 to （3.71±2.51） on day 14（P<0.001）, VAS score of nasal symptoms decreased from （24.86±7.40） on day 0 to （6.84±5.94） on day 14（P<0.001）, VAS score of rhinorrhoea decreased from （6.88±2.06） on day 0 to （1.91±1.81） on day 14（P<0.001）. Rhinoconjunctivitis quality of life questionnaire（RQLQ） score decreased from （94.63±33.35） on day 0 to （44.95±32.28） on day 14（P<0.001）. The incidence of adverse reaction was low and no serious adverse events occurred during the whole experiment. Conclusion:Bencycloquidium bromide nasal spray has significant efficacy and good safety in the treatment of seasonal allergic rhinitis.

Complement Inhibitors in Rare Diseases / 罕见病研究

The complement system is a self-protection mechanism of the human body. The abnormal activation of the complement system is involved in the occurrence and development of various diseases. The application of complement inhibitors in many rare diseases was a milestone in leading to the progress of such disease as paroxysmal nocturnal hemoglobinuria (PNH), atypical hemolytic uremic syndrome (aHUS), and others. Recently, the application of complement inhibitors has gradually expanded to other complement-related diseases. This review summarizes the literature on the current application of complement inhibitors in rare diseases and looks into the prospects of the application in the rare diseases.

Corneal endothelial cell density and morphology of cataract eyes in Danzhou city Hainan province / 中华实验眼科杂志

Objective:To describe corneal endothelial cell density and morphology in cataract eyes in Danzhou city, Hainan province and analyze the influencing factors.Methods:A cross-sectional study was performed.A total of 573 eyes of 573 cataract patients at Danzhou First People＇s Hospital, one of the Poverty Reduction Eye Centres of "Project Vision" , were enrolled from February to December in 2009.TOPCON non-contact corneal endothelial microscope was performed to measure the endothelial cell density, corneal central thickness (CCT), average endothelial cell area, maximum endothelial cell area, minimum endothelial cell area, cell area standard deviation, coefficient of variation in cell area, and percentage of hexagonality.The differences of the above parameters were compared among different genders, eyes and age groups, and the influencing factors were analyzed.This study followed the Declaration of Helsinki.Written informed consent was obtained from each subject prior to entering the study cohort.The study protocol was approved by the Ethics Committee of Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong (No.09-007).Results:The average endothelial cell density of cataract patients was (2 533.00±366.674)/mm 2 (from 846 to 3 969/mm 2), and the CCT was (501.150±31.666) μm.Age ( P<0.01), CCT ( P=0.013), maximum endothelial cell area ( P=0.017), endothelial cell area standard deviation ( P=0.011), coefficient of variation in endothelial cell area ( P=0.001), percentage of hexagonality ( P<0.01), and average endothelial cell area ( P<0.01) were the major influencing factors of endothelial cell density.Endothelial cell density was significanly different in any two age groups (all at P<0.05). The endothelial cell density in cataract patients of 60-79 years old group and ≥80 years old group was lower than that of <60 years old group, whereas the endothelial cell density in patients ≥80 years old subgroups was higher than that in the 60-79 years subgroup, and the difference was statistically significant (all at P<0.01). Gender ( P<0.01), endothelial cell area standard deviation ( P=0.030), coefficient of variation in endothelial cell area ( P=0.012) and endothelial cell density ( P<0.01) were the main influencing factors of CCT.The CCT was (516.27±35.84)μm in male patients, which was significantly higher than (492.20±24.97)μm in female patients, the difference was statistically significant ( t=89.205, P<0.01). The difference of other parameters between different genders was not statistically significant ( P>0.05). There was no significant difference in corneal endothelium parameters between right and left eyes ( P>0.05). Conclusions:Corneal endothelial cell density varies with age, coefficient of variation in cell area, average endothelial cell area and percentage of hexagonality in cataract patients in Danzhou city.The aging degree of corneal endothelial cell is different in patients older than 60 years.

The role of body fat rate in the evaluation of obstructive sleep apnea / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the role of body fat ratio in the evaluation of obstructive sleep apnea(OSA).@*Methods@#A retrospective analysis was made on 174 cases (between November, 2017 and April, 2018 showed that) of sleep monitoring in the Department of Otorhinolaryngology in Peking University Third Hospital. The data included the gender, age, body fat rate, body mass index (BMI), neck circumference, and apnea-hypopnea index (AHI). The above data were analyzed by non parametric correlation analysis, receiver operating characterristic (ROC) curve analysis and multiple factor Logistic regression analysis to study the relationship between the gender,age,body fat rate,BMI,neck circumference and other indexes of the patients with AHI.@*Results@#Nonparametric correlation analysis showed that the correlation from strong to weak to AHI among women was BMI (r=0.621, P<0.001),body fat rate (r=0.602, P<0.001), age (r=0.570, P<0.001), neck circumference (r=0.402, P=0.014), respectively. BMI (r=0.599, P<0.001), neck circumference (r=0.493, P<0.001), body fat rate (r=0.318, P<0.001), and age (r=0.256, P=0.003) among men. ROC curve analysis showed that the strong to weak index (area under curve,AUC) of the AHI>15/h among women was the body fat rate (AUC=0.884, P=0.001), BMI(AUC=0.810, P=0.008), neck circumference (AUC=0.759, P=0.027), age (AUC=0.750, P=0.033), and the male was BMI (AUC=0.765,P<0.001), neck circumference (AUC=0.720, P<0.001), age (AUC=0.634, P=0.008), and body fat rate (AUC=0.632, P=0.010), respectively. Multifactor Logistic regression analysis showed that the body fat rate (OR=1.704,95%CI=1.012-2.870) in women was an independent risk factor for AHI greater than 15/h; the age of male (OR=1. 044, 95%CI=1.005-1.085) and BMI (OR=1.285, 95%CI=1.056-1.562) were independent risk factors for AHI greater than 15/h.@*Conclusion@#Body fat rate can be used as a new indicator for predicting the severity of OSA,especially in adult female population. In adult female moderate to severe OSA patients (AHI>15/h), compared with BMI,neck circumference and age,the body fat rate has the greatest correlation with AHI. Compared with BMI,neck circumference and age,the body fat rate has a decisive role in predicting moderate to severe OSA (AHI>15/h).

ROBIS Evaluation of Quality Assessed by Iconographic Diagnostic Test System / 中国医学影像学杂志

Purpose To evaluate the quality assessed by iconographic diagnostic test system using ROBIS. Materials and Methods"Diagnostic tests, system evaluation, Meta analysis, diagnoses*test, diagnoses*trial, systematic review, meta-analysis" were used as search term to retrieve relevant literatures recorded in CBM, CNKI, Wanfang Data, PubMed, Embase, and Cochrane Library from January. 1, 2014 to December. 31, 2016. After two independent researchers screened the literature and extracted the information, the quality of included literatures was evaluated using ROBIS. Results Totally 219 articles were included in the study, including 93 Chinese literatures and 126 English literatures. The results of subgroup analysis showed that the quality difference between Chinese and English documents was statistically significant (P=0.018); the quality difference between the Chinese literatures and those of other regions was statistically significant (P<0.001); there was no statistical significance in quality difference regarding the year of publication (P=0.34). The ROBIS evaluation results showed that there were only 15 literatures (6.85%) with low-risk, including 2 Chinese literatures and 13 English literatures. Conclusion The quality evaluated by Chinese and English diagnostic test system, which is publicly published in iconographic diagnostic test from 2014 to 2016, is generally low, and the quality of literatures published by domestic scholars and in Chinese is still behind international levels. The maker of system evaluation in this field should prepare their research plans in advance and fully report them in future research, adequately obtain evidence, minimize bias in respects of document screening, information extraction, and evaluation of original research bias, and take into account of results stability, based on which the quality of system evaluation in this field should be further improved.

Effect of sirolimus on erythropoiesis of K562 cell line and patients with pure red cell aplasia in vitro / 中华血液学杂志

Objective@#To understand the effect of sirolimus on the erythropoiesis of K562 cell line and bone marrow cells from pure red cell aplasia (PRCA) patients and normal controls.@*Methods@#Different concentrations (10, 100, 1 000 nmol/L) of sirolimus were added to the K562 cell line or bone marrow cells from PRCA patients or normal controls and cultured 14 days for BFU-E formation. Meanwhile, sirolimus was also added to the serum treated PRCA bone marrow cells to cultivate for the same priod of time.@*Results@#Neither K562 cells, bone marrow cells from PRCA patients or normal controls showed any difference when sirolimus was added to the culture system for BFU-E. However, BFU-E formation decreased after serum was added in PRCA patients (76.40±22.48 vs 136.33±12.58, t=-4.329, P=0.001) and this suppression of BFU-E was partly corrected by 1 000 nmol/L sirolimus treatment (97.14±15.83 vs 76.40±22.48, P=0.038).@*Conclusions@#Sirolimus may modulate the suppression of erythropoiesis by serum instead of directly stimulate the growth of red blood cells in PRCA patients.

Applied occasion of indomethacin on preventing post-endoscopic retrograde cholangiopancreatography pancreatitis / 中华消化内镜杂志

Objective To investigate the optimal timing of indomethacin administration on prevention of post-endoscopic retrograde cholangiopancreatography ( ERCP ) pancreatitis. Methods The patients were randomly divided into the preoperative group and the postoperative group, and given 100 mg indomethacin in rectum within 30 min before and after ERCP, respectively. The serum levels of amylase and lipase were measured preoperatively and 4 h, 24 h postoperatively. The incidences of postoperative complications such as acute pancreatitis, hyperamylasemia, gastrointestinal bleeding, and perforation were assessed. Results A total of 340 patients were enrolled in this study from June 2014 to June 2017. The preoperative group consisted of 163 patients, including 11 cases ( 6. 75％) with post-ERCP pancreatitis ( PEP ) and 32 cases ( 19. 63％) with hyperamylasemia. Meanwhile, 177 patients constituted the postoperative group, with 25 cases ( 14. 12％) with PEP and 55 cases ( 31. 07％) with hyperamylasemia. The incidences of PEP and hyperamylasemia were significantly lower in the preoperative group than that in the postoperative group ( P = 0. 027 and P = 0. 016, respectively ) . Conclusion Preoperative use of indomethacin can better reduce the incidence of PEP than postoperative administration, without incidence increase of other complications.

Advance in research of thrombosis in paroxysmal nocturnal hemoglobinuria / 基础医学与临床

Paroxysmal nocturnal haemoglobinuria ( PNH) is a clonal hematopoietic stem cell disease characterized by intravascular hemolytic anemia , pancytopenia and thrombosis .Although PNH is an non-malignant disease , its complications have very negative impacts on patient's quality of life .The most common serious complication is thrombosis formation .

Modified large-incision manual cataract extraction combined with IOL implantation for high myopia with cataract / 眼科新进展

Objective To evaluate the effectiveness and safety of modified largeincision manual cataract extraction combined with intraocular lens (IOL) implantation for high myopia with cataract.Methods Twenty-eight patients (32 eyes) of high myopia with cataract underwent modified large-incision manual cataract extraction combined with IOL implantation.The nuclear hardness of 20 eyes were in degree Ⅲ,11 eyes were in degree ⅣV,1 eye was in degree V.The follow-up time was form 2 months to 12 months,the visual acuity,refraction and complications were observed and analyzed,Resuits In 32 eyes,the postoperative best corrected visual acuity (BCVA) was better than pre-operation in 28 eyes,4 eyes had no any improvement,in which the server high myopic fundus disease was found.The preoperative and postoperative BCVA were (1.43 ± 0.73) IogMAR and (0.84 ± 0.71) logMAR,and the sphere equivalent were (-15.33 ± 5.03) D and (-1.86 ± 1.41) D,the differences were statistically significant (all P ＜ 0.05).The intraoperative partial suspensory ligament occurred in 1 eye,iris hemorrhage appeared in 1 eye when extracting the lens nucleus;The postoperative mild corneal edema was seen in 11 eyes,hyphema in 1 eye,temporary high IOP in 1 eye,uveitis in 3 eyes,which disappeared within 1 week after treatment.IOL were implanted into capsular bag except 1 eye for partly broken ciliary zonule.There was no IOL dislocation within the follow-up.Conclusion Modified large-incision manual cataract extraction combined with IOL implantation is safe and effective for high myopia with cataract.

The preliminary research in paroxysmal nocturnal hemoglobinuria with thrombosis / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the high risk factors of thrombosis in paroxysmal nocturnal hemoglobinuria (PNH). It has been reported that in Chinese patients with venous thrombosis, the mutation frequency in PROC c.574_576 del (rs199469469), PROC c.565C>T (rs146922325) and THBD c.-151G>T (rs1698852) was higher than that of normal controls, indicating its importance in thrombophilia pathogenesis.</p><p><b>METHODS</b>142 patients with PNH diagnosed between 2009 and 2015 were enrolled in the study. Clinical data were analyzed and thrombophilia risk factors, such as the level of protein C, protein S, antithrombin III, APC resistance, blood fat, phospholipid antibody, were evaluated. Samples from patients and 100 normal controls were detected for the mutations of PROC c.574_576 del (rs199469469), PROC c.565C>T (rs146922325) and THBD c.-151G>T (rs1698852) by Sanger sequence.</p><p><b>RESULTS</b>Of the 142 PNH patients, 21 (14.8%) patients had at least 1 episode of thrombotic event. Only 2 patients had arterial thrombosis and 19 patients had venous thrombosis. The median age of patients with thrombosis was 35 years old, similar to those without episode (40 years old, P=0.687). The ratios of males and females were 1.33 in thrombosis group and 1.57 in non-thrombosis group (P=0.728) , respectively. Patients with thrombosis had the same disease pattern compared with those without episode. Although there was no difference in the level of hemoglobin, WBC and PLT count, and LDH level between patients with thrombosis and those without episode, patients with thrombosis showed higher RBC, higher percentage of CD59(-) granulocytes and RBC, and Flaer(-) granulocytes compared with those without episode. The routine thrombophilia screening tests did not show any difference either between PNH patients and normal controls, or between patients with or without thrombosis. There were two mutations in rs199469469 and rs16984852 sites in patients with PNH, but the mutated patients did not have any thrombosis. Mutation rs146922325 was found in PNH patients. The mutation rate was similar between PNH patients and normal controls, thrombotic PNH and non-thrombotic PNH (P>0.05).</p><p><b>CONCLUSIONS</b>Compared with non-thrombotic patients, PNH thrombotic patients have bigger PNH clone and higher RBC count. There are no differences among the routine thrombophilia factors and the three known venous eligible genes either between PNH patients and normal controls or between thrombotic and non-thrombotic PNH patients.</p>

MRI monitoring in diagnosis and follow-up of iron overload / 中华血液学杂志

<p><b>OBJECTIVE</b>To use the technique of magnetic resonance imaging (MRI) T2* mapping to diagnose and follow-up of patients with iron overload.</p><p><b>METHODS</b>107 patients who were suspected to have iron overload between 2011.7-2014.3 in Peking Union Medical Colleague Hospital were analyzed retrospectively. Patients had the document of MRI T2* value of liver, heart and pancreas, serum ferritin (SF), transferrin saturation (TS), transfusion amount and other related laboratory tests. T2* values were compared with SF and transfusion amount. T2* values in different organs and their relationship with SF were also evaluated. 10 patients who had been adequately chelated for more than half a year were followed up for their SF and T2* values.</p><p><b>RESULTS</b>There were 65 males and 42 females with the median age of 51(8-77)-year-old. They were 50 myelodysplastic syndromes (MDS), 36 aplastic anemia, 10 myelofibrosis, 7 hemachromatosis and 4 thalassemia carriers. Liver T2* value was significantly related to SF (r=0.120, P=0.001), but not related to transfusion amount (r=0.019, P=0.175), whereas cardiac MRI T2* was not related either to SF or to transfusion amount. No correlation of the T2* value was found between liver and heart (r=0.015, P=0.235). 70 patients was detected for liver, heart and pancreas T2* simultaneously. Pancreas T2* was compatible to SF (r=0.061，P=0.039) and cardiac T2* (r=0.110, P=0.005), but not correlated to heptic T2* (r=0.047, P= 0.071) or transfusion amount (r=0.000, P=0.960). For the 10 well-chelated patients, during the half year follow-up period, SF changed significantly from (2 566.5±1 152.2) μg/L before chelation to (1 473.4±803.0) μg/L after chelation(P=0.001), while liver T2* remained the same [(6.0±5.1) ms, (6.3±6.0) ms respectively, P=0.629].</p><p><b>CONCLUSION</b>MRI, although related to SF to some extent, was a valuable additional methods for quantifying iron overload. Iron deposition in different organs might be not related to each other and needed to be evaluated separately. Well-chelation therapy could change SF in half-year follow-up, but T2* change needed longer time to follow-up.</p>

The role of the cerebellum in auditory process and tinnitus / 临床耳鼻咽喉头颈外科杂志

Cerebellum connects with each part of the auditory pathway directly or indirectly, forming the anatomical basis for a cerebellar role in auditory process. Functional imaging studies and clinical observations provide more abundant support for this view. Tinnitus is one of the most common clinical manifestations when the auditory system is impaired and remains unsolved. Basic science researches in neurotransmitter chemistry and molecular biochemistry, together with functional imaging studies, indicate that cerebellum might contribute to the pathophysiology of tinnitus. In this review we summarize the current understanding of cerebellar role in auditory process and tinnitus.

Eustachian tube dysfunction misdiagnosed: a case report / 临床耳鼻咽喉头颈外科杂志

The patient has complained of fullness in her right ear since she took a flight 5 years ago. Pure tone audiometry indicated normal hearing threshold and acoustic immitance proved type A tympanogram in both ears. She visited different doctors over and over again, with every doctor diagnosed her with psychogenic ear fullness. The patient was treated with vasodilative and neurotrophic medicine, together with psychotherapy, but her ear fullness didn't relieve. Three months ago she visited our department. Tubomanometry (TMM) can't find R value under 50mBar and ETS-7 score was zero in her right ear. Eustachian tube dysfunction was diagnosed and the patient was then given nasal decongestants, intranasal corticosteroids and myrtol for treatment. A month later the patient's symptom relieved and TMM showed R value less than 1 under 30mBar and EST-7 score was 14 in the right ear.

The study of symptomatology and electroencephalogram in central region diastematia epilepsy / 中华神经科杂志

ObjectiveTo explore the clinic symptom and the characteristics of video,tightly close,intracranial electroencephalogram (EEG) of patients with central region diastematia epilepsy. Methods Retrospective analysis of 9 patients with central region diastematia epilepsy admitted from June,2007 to August,2009.The characteristics of all patients' seizure symptom and EEG manifestation were analyzed using patients' medical history,video and EEG records.ResultsPatients with central region diastematia epilepsy had relatively long sezure history.The duration of seizure was commonly short,with frequent episode and no obvious intelligence impairment.The seizure was often accompanied with the hyperkinesia in the lower limbs.Scalp EEG showed discharges with low amplitude waves in the mean line area.The superhigh amplitude and regular rhythm slow sharp wave could be found in the diastematia cortex EEG.All patients had an Engel Class Ⅰ outcome after surgery.ConclusionThe seizure symptoms are characteristic in the patients with central region diastematia epilepsy,and some special manifestations can be found in different phase,wave amplitude,rhythm,lead array.

Intelligence, Personality and Mentality of Patients with Intractable Epilepsy / 中国康复理论与实践

@#Objective To explore the characteristic of intelligence, personality and mentality of patients with intractable epilepsy and analyzethe related factors on intelligence. Methods 68 patients with intractable epilepsy and 60 healthy persons were assessed with Raven'sstandard progressive matrices (SPM), Eysenck personality questionnaire (EPQ) and 90 symptoms checklist (SCL-90). The related factors onintelligence were analyzed. Results Compared with controls, the total score and IQ of SPM of the patients decreased significantly (P<0.05).There were 51.4% of intellectual deficiency in patients with intractable epilepsy, which was higher than that of controls (1.7%) (P<0.05).There was no significant difference in score of EPQ and the proportion of personality type between 2 groups (P>0.05). The total score ofSCL-90 and the factor score, such as somatization, interpersonal sensitivity, depression, anxiety and hostility in patients were higher thanthose in controls(P<0.05). Various factors, including the onset age, course of disease, seizure types, frequency, duration, number of drug, thescores of SCL-90 were correlated with the intelligence of epileptic patients (P<0.05). Conclusion The intelligence of many patients with intractableepilepsy were damaged, and many patients were with various psychological barriers. The onset age, course of disease, seizuretypes, frequency, duration and number of drug were important factors related with intellectual disorders in patients with intractable epilepsy.

The combination application of intracranial buried electrode and cortical electrical stimulation in the excision of the epileptogenic zone in the central zone / 中国神经精神疾病杂志

Objective To investigate the combination application of the intracranial buried electrode and electrical stimulation techniques in excising the epileptogenic zone in the central zone.Methods Seven patients with epileptogenic zone located close to or in the central zone of brain were recruited in the present study.The lone term ECoG monitoring and electrical stimulation of the codex were performed to identify the epileptogenic zone and the central zone of the brain after patients received intracranial electrode implants.The epileptogenic zone was excised with maximum preservation of the cen-tral zone.The patients were follow-up for 6 to 12 months,the outcomes were evaluated based on the Engel's scale and the Karnofsky(KPS)score.Results Seven patients did not experience any seizures and their Engei's and KPS scores were markedly improve after operation.Conclusions Intracranial buried electrodes and cortical electrical stimulation can guide the resection of epileptogenic zone in the central zone.Patients have no seizure and no serious dysfunction after operation and their quality of life was improved markedly.