Comparative study on the treatment of rhegmatogenous retinal detachment between foldable capsular body and scleral buckling / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the effectiveness and complications of treating rhegmatogenous retinal detachment(RRD)with foldable capsule body(FCB)and scleral buckling(SB).METHODS: The clinical data of 81 patients(82 eyes)with RRD who underwent surgery at our hospital from March 2019 to April 2022 were retrospectively analyzed. The differences in retinal reattachment rate, best-corrected visual acuity, the absorption of subretinal fluid, postoperative discomfort and incidence of complications between the two treatments were compared.RESULTS: The retinal reattachment rate was 96% in the FCB group and 92% in the SB group, with no significant difference between the two groups(P>0.05). The best corrected visual acuity of the affected macular eyes was different in the both groups(P<0.01). Both groups effectively promoted the absorption of subretinal fluid. The operation time of FCB group was 16.50(12.75, 25.00)min, while it was 38.00(36.25, 41.75)min in the SB group(P<0.001). Patients in the FCB group also had significantly lower eyelid swelling and pain symptoms than those in the SB group(P<0.001). The visual analogue scale(VAS)score at 1d after operation was 1.00(0.00, 2.00)in the FCB group and 3.00(2.00, 3.00)in the SB group(P<0.001).CONCLUSION: FCB is a safe and effective surgical method to treat RRD that can alleviate patient's pain. Furthermore, FCB has a significantly shorter operation time and milder postoperative adverse reactions than SB.

Clinicopathological characteristics of gastric SMARCA4-deficient undifferentiated/rhabdoid carcinoma / 中华病理学杂志

Objective: To investigate the clinicopathological features and immunohistochemical phenotypes of gastric SMARCA4-deficient undifferentiated carcinoma, and to discuss the daily diagnostics of this entity and analyze its prognosis. Methods: The cases of gastric SMARCA4-deficient undifferentiated carcinoma diagnosed at the Department of Pathology, Peking University Cancer Hospital, China from January 2010 to August 2022 were collected. The histological sections were reviewed, the immunohistochemical results and clinicopathological features were analyzed, and relevant literature was reviewed. Results: Pure foci of undifferentiated carcinoma were seen in 7 cases, and 1 case was accompanied by a moderately differentiated tubular adenocarcinoma component. Undifferentiated carcinoma foci showed similar sheet-like or solid diffuse growth pattern, medium-sized tumor cells characterized by 1-2 nucleoli, and abundant cytoplasm and rhabdoid appearance. The average patient age was 65±8 years. Six patients were male and 2 were female. Immunohistochemical staining showed that undifferentiated carcinoma of all 8 tumors were negative for SMARCA4 (BRG1). Among 7 patients who underwent SMARCA2 (BRM) and SMARCB1 (INI1) staining, 4 cases showed loss of BRM expression, 2 cases showed weakly positive staining, and 1 case was diffusely positive, but all 7 cases were diffusely strong positive for INI1. The neuroendocrine marker, synaptophysin, was weakly positive in 5 cases, while CgA and CD56 were negative in 8 cases. Ki-67 index was more than 70%. Two cases were mismatch repair deficient and showed the loss of MLH1/PMS2 expression, while 1 case showed only MSH2 loss. PD-L1 staining showed that combined positive score (CPS)≥1 in 4 cases (CPS ranging from 1 to 55) and CPS<1 in the other 3 cases. Four patients had clinical stage Ⅳ disease. Two of them died within 3 months after diagnosis. Conclusions: Gastric SMARCA4-deficient undifferentiated carcinoma/rhabdoid carcinoma is a rare group of highly malignant tumors with a poor prognosis. Loss of the core subunit of SWI/SNF complex may be associated with the development of dedifferentiated histological pattern and aggressive tumor progression, which may be more frequently accompanied with mismatch repair deficiency.

Effects of propiconazole on physiological and biochemical properties of Panax notoginseng and dietary risk assessment / 中国中药杂志

To study the residue and dietary risk of propiconazole in Panax notoginseng and the effects on physiological and bioche-mical properties of P. notoginseng, we conducted foliar spraying of propiconazole on P. notoginseng in pot experiments. The physiolo-gical and biochemical properties studied included leaf damage, osmoregulatory substance content, antioxidant enzyme system, non-enzymatic system, and saponin content in the main root. The results showed that at the same application concentration, the residual amount of propiconazole in each part of P. notoginseng increased with the increase in the times of application and decreased with the extension of harvest interval. After one-time application of propiconazole according to the recommended dose(132 g·hm~(-2)) for P. ginseng, the half-life was 11.37-13.67 days. After 1-2 times of application in P. notoginseng, propiconazole had a low risk of dietary intake and safety threat to the population. The propiconazole treatment at the recommended concentration and above significantly increased the malondialdehyde(MDA) content, relative conductivity, and osmoregulatory substances and caused the accumulation of reactive oxygen species in P. notoginseng leaves. The propiconazole treatment at half(66 g·hm~(-2)) of the recommended dose for P. ginseng significantly increased the activities of superoxide dismutase(SOD), peroxidase(POD), and catalase(CAT) in P. notoginseng leaves. The propiconazole treatment at 132 g·hm~(-2) above inhibited the activities of glutathione reductase(GR) and glutathione S-transferase(GST), thereby reducing glutathione(GSH) content. Proconazole treatment changed the proportion of 5 main saponins in the main root of P. notoginseng. The treatment with 66 g·hm~(-2) propiconazole promoted the accumulation of saponins, while that with 132 g·hm~(-2) and above propiconazole significantly inhibited the accumulation of saponins. In summary, using propiconazole at 132 g·hm~(-2) to prevent and treat P. notoginseng diseases will cause stress on P. notoginseng, while propiconazole treatment at 66 g·hm~(-2) will not cause stress on P. notoginseng but promote the accumulation of saponins. The effect of propiconazole on P. notoginseng diseases remains to be studied.

Caspase-1/-11 participates in LPS-induced sepsis-associated acute kidney injury by cleaving GSDMD / 生理学报

The present study was aimed to investigate whether Gasdermin D (GSDMD)-mediated pyroptosis participated in lipopolysaccharide (LPS)-induced sepsis-associated acute kidney injury (AKI), and to explore the role of caspase-1 and caspase-11 pyroptosis pathways in this process. The mice were divided into four groups: wild type (WT), WT-LPS, GSDMD knockout (KO) and KO-LPS. The sepsis-associated AKI was induced by intraperitoneal injection of LPS (40 mg/kg). Blood samples were taken to determine the concentration of creatinine and urea nitrogen. The pathological changes of renal tissue were observed via HE staining. Western blot was used to investigate the expression of pyroptosis-associated proteins. The results showed that the concentrations of serum creatinine and urea nitrogen in the WT-LPS group were significantly increased, compared with those in the WT group (P < 0.01); whereas serum creatinine and urea nitrogen in the KO-LPS group were significantly decreased, compared with those in the WT-LPS group (P < 0.01). HE staining results showed that LPS-induced renal tubular dilatation was mitigated in GSDMD KO mice. Western blot results showed that LPS up-regulated the protein expression levels of interleukin-1β (IL-1β), GSDMD and GSDMD-N in WT mice. GSDMD KO significantly down-regulated the protein levels of IL-1β, caspase-11, pro-caspase-1, caspase-1(p22) induced by LPS. These results suggest that GSDMD-mediated pyroptosis is involved in LPS-induced sepsis-associated AKI. Caspase-1 and caspase-11 may be involved in GSDMD cleavage.

Research advances in chest tightness variant asthma / 中华预防医学杂志

Chest tightness variant asthma (CTVA) is a special type of asthma with chest tightness as the only or main symptom. Due to the lack of typical asthma symptoms such as coughing, wheezing, shortness of breath, and positive signs in chest, it is easy to be missed or misdiagnosed in clinical practice. The onset of chest tightness variant asthma is insidious, and there is few research and attention both domestic and international, so there is no unified diagnosis and treatment standard especially in childhood asthma. This article expounds the related research advances in chest tightness variant asthma, in order to increase clinical attention and provide reference and basis for the prevention of the disease as well as the formulation of diagnosis and treatment strategies.

Research progress of Eubacterium and its metabolite short-chain fatty acids in regulating type 2 diabetes mellitus / 中华预防医学杂志

Intestinal flora and its metabolites are closely related to the progression of type 2 diabetes mellitus(T2DM). Eubacterium is one of the dominant intestinal flora, and its metabolites short-chain fatty acids (SCFAs) play a leading role in regulating intestinal metabolic balance. It has been reported that SCFAs can regulate the secretion of glucagon-like peptide-1, improve the function of pancreatic β cells, participate in bile acids metabolism and regulate the production of inflammatory factors in T2DM. Based on the above research background, this article mainly reviews the relationship between Eubacterium and its metabolite SCFAs and T2DM and its regulatory mechanism.

Computer simulation of molecular docking between methylene blue and some proteins of Porphyromonas gingivalis / 北京大学学报(医学版)

OBJECTIVE@#To study the binding target of photosensitizer and bacteria in antimicrobial photodynamic therapy with computer-simulated target prediction and molecular docking research methods and to calculate the binding energy.@*METHODS@#The protein names of Porphyromonas gingivalis (Pg) were obtained and summarized in Uniprot database and RCSB PDB database; the structure diagrams of methy-lene blue were screened in SciFinder database, PubChem database, ChemSpider database, and Chemical Book, and ChemBioDraw software was used to draw and confirm the three-dimensional structure for target prediction and Cytoscape software was used to build a visual network diagram; a protein interaction network was searched and built between the methylene blue target and the common target of Pg in the String database; then we selected FimA, Mfa4, RgpB, and Kgp K1 proteins, used AutoDock software to calculate the docking energy of methylene blue and the above-mentioned proteins and performed molecular docking.@*RESULTS@#The target prediction results showed that there were 19 common targets between the 268 potential targets of methylene blue and 1 865 Pg proteins. The 19 targets were: groS, radA, rplA, dps, fabH, pyrG, thyA, panC, RHO, frdA, ileS, bioA, def, ddl, TPR, murA, lepB, cobT, and gyrB. The results of the molecular docking showed that methylene blue could bind to 9 sites of FimA protein, with a binding energy of -6.26 kcal/mol; with 4 sites of Mfa4 protein and hydrogen bond formation site GLU47, and the binding energy of -5.91 kcal/mol, the binding energy of LYS80, the hydrogen bond forming site of RgpB protein, was -5.14 kcal/mol, and the binding energy of 6 sites of Kgp K1 protein and the hydrogen bond forming site GLY1114 of -5.07 kcal/mol.@*CONCLUSION@#Computer simulation of target prediction and molecular docking technology can initially reveal the binding, degree of binding and binding sites of methylene blue and Pg proteins. This method provides a reference for future research on the screening of binding sites of photosensitizers to cells and bacteria.

Value of three-dimensional speckle-tracking imaging in evaluating left ventricular systolic function and its correlation with peripheral arterial elasticity in children with simple obesity: a prospective study / 中国当代儿科杂志

OBJECTIVES@#To study the application of three-dimensional speckle-tracking imaging in evaluating left ventricular systolic function and its correlation with peripheral arterial elasticity in children with simple obesity.@*METHODS@#Random sampling combined with convenience sampling was used to obtain research samples, and then the samples were divided into an obesity group (23 cases), an overweight group (21 cases), and a normal group (24 cases). Three-dimensional speckle-tracking imaging was used to measure the global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) of the left ventricle. An automatic arteriosclerosis tester was used to measure ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV). These parameters were compared among the three groups. The correlation of three-dimensional speckle-tracking parameters with ABI and baPWV was evaluated.@*RESULTS@#There were no significant differences in GLS, GRS, and GCS between the obesity and normal groups (P>0.05). The overweight group had a significantly higher GLS than the normal group [(-24±7) vs (-19±12), P<0.05]. The obesity and overweight groups had a significantly lower ABI than the normal group [(1.00±0.09)/(1.09±0.13) vs (2.25±0.13), P<0.05). The obesity group had a significantly higher baPWV than the normal group [(978±109) vs (905±22), P<0.05]. In the children with obesity, GLS was positively correlated with baPWV (r=0.516, P<0.05) , but not correlated with ABI (P>0.05), and GCS and GRS had no significant correlation with ABI or baPWV (P>0.05).@*CONCLUSIONS@#There are varying degrees of changes in left ventricular systolic function and peripheral arterial elasticity in children with simple obesity, and there is a certain correlation between them.

Advances in loop-mediated isothermal amplification in the diagnosis of tuberculosis / 中国热带医学

@#Abstract: The loop-mediated isothermal amplification (LAMP) technique is a technique for the specific and efficient amplification of target fragments at a constant temperature using two pairs of specially designed primers and a strand displacement activity DNA polymerase. LAMP technique is a simple, rapid, specific, sensitive and cost-effective nucleic acid amplification method, and therefore has a promising future in the field rapid detection of Mycobacterium tuberculosis and grassroots applications. In this review, the basic principles and characteristics of the LAMP technique, the main molecular markers for the diagnosis of tuberculosis, and the use of different molecular markers and various types of novel techniques in the diagnosis of pulmonary tuberculosis, extrapulmonary tuberculosis, and drug-resistant tuberculosis were described. The LAMP technique has been widely used in the diagnosis of tuberculosis with high sensitivity and specificity, but the technique still has some shortcomings. This paper reviews the progress of its application in tuberculosis in recent years and provides an outlook on its development, with a view to providing a rational research direction for rapid diagnosis of tuberculosis in a resource-limited environment.

Clinical characteristics of IgE-mediated cow's milk protein allergy in children / 中华儿科杂志

Objective: To analyze the clinical features of IgE-mediated cow's milk protein allergy (CMPA) in children aged 0-5 years. Methods: This cross-sectional study collected the data on children diagnosed with CMPA in the Department of Allergy at the Children's Hospital of the Capital Institute of Pediatrics from October 2019 to November 2020 and improved peripheral blood routine,total IgE defection, milk specific IgE (sIgE) defection,SPT and milk component defection,diagnosis of severe anaphylaxis based on clinical manifestations. Rank-sum test and chi-square test are used for statistical analysis of clinical characteristics between groups. Results: A total of 106 children (67 boys and 39 girls) were enrolled with the age of 15 (8, 34) months, including 42 cases (≤ 1 year of age), 39 cases (>1-<3 years of age) and 25 cases(≥3 years of age), the onset age of 6 (5, 8) months. Among them, 95 cases (89.6%) were reacted after consuming milk or its products, 42 cases (39.6%) had reaction due to skin contact and 11 cases (10.4%) reacted after exclusive breastfeeding. The onset time of milk product consumption was 45 (1, 120) min, skin contact pathway was 10 (5, 30) min and symptoms in breastfeeding pathway was 121 (61, 180) min. There was statistical difference among the time of symptoms (χ2=77.01, P<0.001).The cutaneous reaction was most common (100 cases, 94.3%), followed by digestive (20 cases, 18.9%) and respiratory (16 cases, 15.1%), and the nervous symptoms (1 case, 0.9%) were uncommon and 24 cases (22.6%) had at least one episode of anaphylaxis. There were 87 cases (82.1%) also diagnosed with other food allergies, 94 cases (88.7%) with previous eczema, 57 cases (53.8%) with history of rhinitis, and 23 cases (21.7%) with history of wheezing. The total IgE level was 191.01 (64.71, 506.80) kU/L, and the cow's milk sIgE level was 3.03 (1.11, 15.24) kU/L. The maximum diameter of the wheal in SPT was 8.2 (4.0, 12.0) mm. Component resolved diagnosis showed that 77 cases (81.9%) were sensitized to at least one out of 4 main components, including casein, α lactalbumin, β lactoglobulin and bovine serum albumin.The possibility of anaphylaxis in children with milk sIgE grade Ⅳ-Ⅵ was higher than that in children with grade 0-Ⅲ (57.7% (15/26) vs. 12.5% (10/80), OR=9.545, 95%CI 3.435-26.523). Children with milk SPT ≥+++ had a higher probability of anaphylaxis than those with milk SPT ≤++ (34.4% (11/32) vs. 11.5% (3/26), OR=4.016, 95%CI 0.983-16.400). Anaphylaxis were more common in α lactalbumin positive children than in negative children (34.3% (13/38) vs. 14.2% (8/56), χ2=1.23，P=0.042). Conclusions: CMPA in children has early onset and diversified clinical manifestations, which are mainly cutaneous symptoms. Most children are sensitized to at least one allergen component. Serum sIgE level, SPT reaction and allergen components play important roles in the diagnosis and evaluation of CMPA, and higher milk sIgE level may predict a higher risk of anaphylaxis.

Evidence-based guidelines for food allergy of children in China / 中华实用儿科临床杂志

The diagnosis of food allergy in children is one hotspot attracting people′s attention in recent years.The incidence of it shows an increasing trend which exposes problems in the understanding of children′s food allergy in China, especially in the misdiagnosis and missed diagnosis.To further standardize the diagnosis and treatment of food allergy in children, based on the current domestic, foreign guidelines and relevant research evidence, the guideline recommends 16 clinical hot-button issues in the 4 aspects of diagnosis, treatment, prognosis, and prevention.Finally, a diagnosis flowchart has been formulated.The guideline aims to improve the standard diagnosis and treatment of food allergies in children in China.

Clinical study of early-onset sepsis with positive blood culture in extremely preterm and super preterm infants / 中华实用儿科临床杂志

Objective:To study the clinical features and high-risk factors of early-onset sepsis (EOS) in extremely preterm and super preterm infants.Methods:Retrospective study.Clinical data of extremely preterm and super preterm infants with the gestational age < 32 weeks were obtained from the clinical database of breast milk quality improvement registration in the Woman′s Hospital of Nanjing Medical University between January 2019 and December 2019.EOS cases were enrolled in the EOS group, and the remaining were enrolled in the control group.Risk factors for EOS, distribution of pathogenic bacteria, clinical features, complications, and outcomes between groups were analyzed.Measurement data were compared between the independent sample t-test.Counting data between groups were compared by the Chi- square test, corrected Chi- square test or Fisher′ s exact test.Multivariable Logistic regression model was used to analyze the risk factors of EOS in extremely and super preterm infants. Results:A total of 347 eligible neonates were recruited, including 22 neonates with EOS and 325 neonates without EOS.The incidence rate of EOS was 6.3%.Multivariate Logistic regression analysis showed that cesarean delivery was the protective factor for EOS ( OR=0.277, 95% CI: 0.091-0.847); while maternal prenatal infection ( OR=2.750, 95% CI: 1.053-2.908), fetid amniotic fluid ( OR=3.878, 95% CI: 1.344-11.187), chorioamnionitis ( OR=4.363, 95% CI: 1.552-12.236) and intubation ( OR=3.883, 95% CI: 1.133-13.306) were risk factors for EOS.A total of 22 strains of pathogenic bacteria were cultured in the EOS group, including 14 strains (63.6%) of Gram-positive bacteria, 7 strains (31.8%) of Gram-negative bacteria and 1 strain (4.6%) of fungus.The acute respiratory distress syndrome (54.5%), poor peripheral circulation perfusion (54.5%), mental depression (50.0%), and procalcitonin>0.5 mg/L (40.9%) were the main clinical features of EOS.Compared with the control group, extremely preterm and super preterm infants with EOS had a significantly higher rate of septic shock, disseminated intravascular coagulation, severe intraventricular hemorrhage (≥Ⅲ), acute respiratory distress syndrome (ARDS), and bronchopulmonary dysplasia( χ2=36.696, 33.255, 13.534, 95.455 and 3.886, respectively; all P<0.05). Conclusions:Maternal perinatal infection, odor amniotic fluid, chorioamnionitis and delivery room tracheal intubation are high-risk factors for preterm and super preterm infants with EOS, which can be prevented by cesarean section.Gram-positive cocci are the main pathogenic bacteria of EOS.ARDS and poor peripheral circulation perfusion are the main clinical manifestations of EOS, which increase the occurrence of severe intracranial hemorrhage and other complications.

Long-term trajectories of lung function and risk factors in children with bronchial asthma / 中华实用儿科临床杂志

Objective:To establish the long-term trajectories of lung function in children with bronchial asthma (asthma) and explore the risk factors of persistent pulmonary dysfunction.Methods:A retrospective cohort study was conducted.Children with asthma aged above 14 years who had been followed up regularly and completed pulmonary function testing in Children′s Hospital of Capital Institute of Pediatrics were enrolled in the study from January to December 2019.Their lung function data and clinical information were collected.The latent class growth model (LCGM) was used to fit the change of lung function in children with asthma, and different trajectory groups were established.Comparison between groups was performed by t-test, ANOVA or Chi- square test.The risk factors for the lung function trajectory were analyzed by the multivariate Logistic regression method. Results:A total of 173 children with asthma, aged from 6 to 17, were enrolled, and 1 160 lung function tests were completed.Four forced expiratory volume in the first second/forced vital capacity (FEV 1/FVC) latent class trajectory groups were established, including persistent high level [27 cases (15.6%)], above average level [66 cases (38.1%)], below average level [66 cases (38.1%)], and persistent low level [14 cases (8.1%)]. In all the 4 different trajectory groups, the FEV 1/FVC values were significantly different among patients of different ages (all P<0.05). The FEV 1/FVC values of patients at all ages in the persistent high level group were above 90%.The FEV 1/FVC values of patients in other 3 level groups decreased as a whole as the age increased.FEV 1/FVC of patients in the persistent low level group decreased to below 80% when they entered the school age period and approached 70% in adolescence.The trajectory and fluctuation of maximal midexpiratory flow (MMEF), which represents the small airway function, were similar to those of FEV 1/FVC.Risk factor analysis showed that the risk of lung function decreasing below the average level in children with typical asthma was 11.940 times higher than that in children with cough variant asthma ( P=0.008). The risk of lung function deteriorating to below the average level in children with multiple allergen sensitivities was 7.462 times higher than that in children with single allergen sensitivity ( P=0.015). Children taking drugs irregularly were 6.337 times more likely to suffer persistent low lung function than children taking drugs regularly ( P=0.035). Boys were 6.186 times more likely to suffer a lung function reduction to below the average level than girls ( P=0.002). Conclusions:Four long-term trajectories of lung function in asthmatic children aged 6 to 17 years can be established: persistent high level, above average level, below average level and persistent low level.The long-term lung function of nearly a half of the asthmatic children is below the average level.Many children develop persistent airflow limitation in adolescence, and few at school age.Typical asthma, multiple allergen sensitivities, irregular medication and boy were the risk factors of long-term lung function reduction.

Cell Apoptosis Mechanism and Traditional Chinese Medicine Intervention in Diabetic Peripheral Neuropathy： A Review / 中国实验方剂学杂志

Diabetic peripheral neuropathy is a common complication of diabetes， and its pathogenesis is complex. Its high morbidity can result in disability， teratogenesis， and death in diabetic patients. At present， the pathogenesis of diabetic peripheral neuropathy has not been clearly elucidated， which may be related to oxidative stress， inflammatory response， microcirculation dysfunction， metabolic abnormalities， etc. Recent studies have found that apoptosis plays an important role in the pathogenesis of diabetic peripheral neuropathy. The three pathways， i.e.， mitochondrial pathway， death receptor pathway， and endoplasmic reticulum pathway， jointly regulate the cell apoptosis in the body. Traditional Chinese medicine， with definite efficacies in the treatment of diabetic peripheral neuropathy， is advantageous in overall regulation and multi-target and multi-pathway treatment. As reported， the active ingredients in Chinese medicine and Chinese medicinal compounds can alleviate diabetic peripheral neuropathy by regulating apoptosis signaling pathways. Furthermore， apoptosis pathways are expected to be potential targets for new drugs against diabetic peripheral neuropathy following oxidative stress. Therefore， this paper， taking apoptosis as the entry point， reviewed the research progress on TCM intervention in diabetic peripheral neuropathy in recent years to provide references for the clinical prevention and treatment of diabetic peripheral neuropathy and the development of new drugs.

Clinical characteristics of 21 children with wheat allergy / 中华实用儿科临床杂志

Objective:To analyze and summarize the clinical features of wheat allergy in children, and to increase the awareness and diagnosis of food allergy in children.Methods:Children suspected with wheat allergy in the Department of Allergy, Children′s Hospital of Capital Institute of Pediatrics from December 2018 to November 2019 were included.Clinical data were collected, including the demographic profile, serum allergen specific immunoglobulin E(IgE) detection, peripheral eosinophil detection, and skin prick testing.Results:A total of 21 cases were included, consisting of 15 males and 6 females, aged (21.5±12.8) months.The children developed allergic symptoms after intake of wheat products or contact with wheat flour.The most common clinical manifestations were cutaneous (20/21 cases, 95.2%), followed by respiratory (7/21 cases, 33.3%), digestive (6/21 cases, 28.6%) and nervous (1/21 cases, 4.8%) symptoms.Eleven children had anaphylaxis.Laboratory allergy test showed that the detection level of serum wheat-specific IgE in 21 children was 1.46 to 100.00 kU/L, and when the specific IgE level was in grade Ⅴ or above, the risk of serious allergic reaction was increased in children ( P<0.05). Five of them tested positive in the wheat skin prick test.The peripheral eosinophil ratio in children was 0.04-0.12.All children had a history of other food allergies and family allergies. Conclusions:Wheat allergy in children has early onset and diversified clinical manifestations, mainly skin symptoms.Serum specific IgE detection shows an important role in the diagnosis and evaluation of wheat allergy.The highly sensitized individuals are prone to anaphylaxis.

Evaluation of safety and consistency of inhaled allergen extracts in the diagnosis of allergic diseases in children / 中华实用儿科临床杂志

Objective:To investigate the safety and consistency of domestic inhaled allergen extracts in the diagnosis of allergic diseases in children.Methods:Nine thousand five hundred and sixty-three children diagnosed with allergic diseases from September 2018 to June 2020 in Children′s Hospital Affiliated to Capital Institute of Pedia-trics were selected in this study, and all of them were subjected to skin prick test(SPT), and 415 of them were subjected to serum specific IgE (sIgE) test at the same time.The adverse events during SPT were recorded and the consistency of the results between SPT and sIgE test was analyzed.Results:There were 14 cases with adverse events in 9 563 patients, and the overall incidence was 0.15%.The incidence of adverse events was 0.07% (2/2 581 cases) in the 1-5 years old group, 0.19% (12/6 197 cases) in the 6-11 years old and 0 in the 12-17 years old group.The severity of all these events was grade Ⅰ.Out of the 14 cases with adverse events, only 1 case was considered to be related to allergen preparations, with the incidence being 0.01% (1/9 563 cases). The Kappa index showed that the results of dermatophagoides pteronyssinus, dermatophagoides farinae, alternaria and artemisia measured by SPT and sIgE were almost the same.There was high consistency between tree pollens and ragweed ( P<0.01), and moderate consistency between aspergillus fumigatus ( P<0.01). When the results of sIgE were used as the diagnostic criteria, the Youden index for the results of SPT ranged from 0.76 to 0.89, with aspergillus fumigatus (0.76) and tree pollens mixture (0.79) as the lowest.The positive likelihood ratio for most of the inhaled allergens was more than 10 except for tree pollens mixture (7.12) and dermatophagoides farinae (9.10). The negative likelihood ratio for most of the inhaled allergens was less than or equal to 0.1 except for aspergillus fumigatus (0.19). Conclusions:The domestic inhaled allergen extracts had high safety in the clinical application of SPT, and their results of SPT had good consistency with those of serum sIgE, which was conducive to the diagnosis and evaluation of allergic diseases in children.

Chemical constituents of Physalis minima / 中国中药杂志

Fifteen compounds(1-15) were isolated from the 95% EtOH extract of the whole herb of Physalis minima by various chromatography techniques including silica gel, Sephadex LH-20, middle chromatogram isolated gel(MCI), octadecyl silica(ODS), and semi-preparative high performance liquid chromatography(HPLC). Their structures were elucidated by infrared spectroscopy(IR), ultraviolet spectroscopy(UV), high-resolution electrospray ionization mass spectrometry(HR-ESI-MS), nuclear magnetic re-sonance(NMR), and circular dichroism(CD) as(5S)-5,11-dihydroxy-3-methyl-5-pentylfuran-2(5H)-one(1), withaphysalin R(2), withaphysalin Q(3), withaphysanolide A(4), phaseic acid(5), grasshopper ketone(6), 3S,5R-dihydroxy-6S,7-megastigmadien-9-one(7), vanillic acid(8), 2-trans,4-trans-abscisic acid(9), capillasterolide(10), 5,3'-dihydroxy-3,7,4'-trimethoxyflavone(11),(-)-loliolide(12), 4-hydroxyacetophenone(13), acetosyringone(14), and aurantiamide acetate(15). Compound 1 was a new butenolide, and compounds 5-7 and 10-12 were isolated from the Physalis for the first time. Compounds 4, 13, and 15 were isolated for the first time from P. minima. Moreover, their anti-inflammatory activity was evaluated in vitro. Compound 12 was found to possess an inhibitory effect on the transcription of an NF-κB-dependent reporter gene in LPS-induced 293 T/NF-κB-luc cells at 10 μmol·L~(-1), showing an inhibitory rate of 62.31%±4.8%.

Current situation and exploration of standardized asthma clinic for children in China / 中华实用儿科临床杂志

Objective:To understand the present situation of the construction of standardized asthma clinic for children in China, to explore the problems existing in the process of construction, and to promote the healthy development of standardized clinic construction.Methods:The process and current situation of the construction of standar-dized asthma clinics for children in China were reviewed and investigated, and the practical significance of the China Children′s Asthma Action Plan (CCAAP) in the construction of standardized asthma clinics for children was explored.Results:(1)By December 2020, 1 289 standardized asthma clinics for children and 135 regional demonstration centers had been built; 56 training sessions had been held, with a total of 2 560 doctors and 650 nurses trained, covering 2 560 hospitals across the country; and 4 518 patient education sessions were held.Online publicity covers a total of 1 million person-times, with an annual average of 1.33 million patients.(2)CCAAP improved the quality control level of standardized asthma clinic and promoted the standardized management of children.Conclusions:Through process optimization, professional evaluation, individual health education and real-time disease monitoring, standardized asthma clinic for children with asthma can effectively enhance asthma management awareness of children and their parents, improve disease awareness, and promote better control of asthma.It is an effective management model of asthma in children at present, and it is worthy of clinical promotion.CCAAP plays a good role in the construction of standardized outpatient clinic for asthma in children.The construction of standardized asthma clinic for children in China has achieved remarkable results, and the development trend is good in the future.

Application of Chinese medicine in enhanced recovery around surgery in perioperative period of laparoscopic anterior resection for rectal cancer patients / 国际中医中药杂志

Objective:To explore the application of enhanced recovery around surgery (CMERAS) by integrated Traditional Chinese Medicine & western medicine in perioperative period of laparoscopic anterior resection for rectal cancer patients.Methods:100 patients with rectal cancer who were treated by laparoscopic anterior resection in Shuguang Hospital from July 2017 to July 2019 were divided into two groups with random number table method, 50 patients in each group. The control group received enhanced recovery after surgery (ERAS) perioperative treatment and the observation group received CMERAS perioperative treatment. Both groups were treated for 7 days. The degree of intestinal cleansing during the operation and postoperative rehabilitation quality were observed of the two groups, including the time of first exhaust, hospitalization time and the incidence of complications. Serum CRP level was detected by immunoturbidimetry, serum IL-6 level was detected by chemiluminescence immunoassay and peripheral blood CD4, CD8 and CD4/CD8 were detected by flow cytometry. Adverse reactions were recorded for the two groups.Results:There was no significant difference in the degree of intestinal cleansing between the two groups during operation ( Z=-1.140, P=0.254). The first postoperative exhaust time in the observation group (29.7 ± 4.6 h vs. 36.1 ± 3.8 h, t=7.590) was earlier than that of the control group, the hospitalization time (4.2 ± 0.5 d vs. 4.7 ± 0.6 d, t=4.379) was less than that of the control group, and the incidence of complications [8.0% (4/50) vs. 30.0% (15/50), χ2=6.498] was lower than that of the control group ( P<0.01). On the third day after the operation, serum CRP (11.84 ± 4.69 mg/L vs. 23.63 ± 5.04 mg/L, t=12.106) and IL-6 (34.31 ± 5.93 ng/L vs. 44.39 ± 8.81 ng/L, t=6.714) in the observation group were lower than those in the control group ( P<0.05). CD4 levels [(37.74 ± 7.28)% vs. (33.55 ± 5.07)%, t=-3.344], CD4/CD8 ratio (1.36 ± 0.27 vs. 1.13 ± 0.22, t=-4.920) were higher than those in the control group ( P<0.01), and CD8 levels [(28.04 ± 4.68)% vs. (30.22 ± 4.04)%, t=2.487] was lower than that of the control group ( P<0.05). There were no adverse reactions in two groups during the treatment. Conclusion:CMERAS could promote the perioperative recovery of patients with rectal cancer if treated with laparoscopic anterior resection and fewer complications would occur.

Investigation on the current status of silica dust hazard in workplaces in Jiangxi Province / 中国职业医学

OBJECTIVE: To analyze the current status of silica dust hazard in workplaces of Jiangxi Province. METHODS: The level of silica dust in the air of workplaces, occupational health examination of the dust-exposed workers and diagnosis of occupational disease in 1 557 enterprises in Jiangxi Province were investigated and analyzed. RESULTS: The 1 557 enterprises were included in eight industries, and the main types of enterprises were non-coal mining, ceramic products manufacturing and stone processing industry(a total of 85.16%). There were 4 029 jobs/positions that were involved in exposure to silica dust in these workplaces. Among them, the exposure concentration of time weighted average(C_(TWA)) of total dust and respirable dust exceeded 21.52% and 20.55%, respectively. The posts where the total dust and respirable dust that exceed the standard were found in the quartz sand processing industry, non-ferrous metal smelting industry and stone processing industry, that were the top three among the eight industries(all P<0.01). Among the 828 posts with C_(TWA) of respiratory dust exceeding the standard, the C_(TWA) exceeding rate of mild-, moderate-and high-hazardous jobs were 3.87%(156/4 029), 1.66%(67/4 029) and 15.02%(605/4 029), respectively. Among 23 643 dust-exposed workers, the detection rates of occupational contraindications and suspected silicosis were 2.06% and 1.51%, and the prevalence of silicosis was 1.21%. CONCLUSION: Silica dust hazard in workplaces of quartz sand processing industry, non-ferrous metal smelting industry and stone processing industry are serious in Jiangxi Province. The supervision and management of occupational health should be further strengthened to guarantee the occupational health of workers.