The 494th case: acute pancreatitis, acute acalculous cholecystitis and anaphylaxis / 中华内科杂志

A young male patient with abdominal pain and fever was diagnosed as acute hyper-triglyceridemicpancreatitis is clear. During the recovery of pancreatitis, the patient developed acute acalculous cholecystitis, as well as carbapenem-resistant Enterobacter infection and Cytomegaloviremia, and had anaphylaxis for several times after the use of antibiotics, which cannot be completely explained by drug allergy. This paper analyzes the possible causes of multiple diseases in the same patient in detail.

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.

Diagnosis progress in component-resolved diagnostics of food allergy / 中华实用儿科临床杂志

IgE-mediated food allergy is a common health problem worldwide, and the incidence of food allergy in China is also increasing gradually in the past decades.However, the traditional diagnostic measurements for food allergen specific IgE (sIgE) are based on the in- vivo or in- vitro tests of the intact allergen extracts, with low specificity and sensitivity, as well as limited diagnostic information.Therefore, the clinical diagnosis of food allergies often requires an oral food challenge test, which increases the suffering and risk of patients.Along with the development of component-resolved diagnostics (CRD) of food allergy, the sIgE against a single allergenic component can be measured quantitatively, thus generating the concept of " CRD" , which makes food allergy diagnosis more accurate and helps people distinguish cross allergens, determine the severity of the disease and the risk of severe allergic reactions, and predict the efficacy of immunotherapy.Besides, the diagnostic accuracy would be enhanced significantly and the reliance on oral food challenge tests would be reduced.In this review, the new progress in the diagnosis of common food allergen components would be summarized, and the advantages of CRD would be discussed.

Expression,purification and bioimformatics analysis of allergen protein Profilin from silkworm (Bombyx mori) / 中国免疫学杂志

Objective:To obtain recombinant Profilin of silkworm,identify its immunogenicity,predict its B cell epitopes and construct the evolutionary trees. Methods: The nucleotide sequence of Profilin was acquired from NCBI,synthesized it and cloned it into pET-28 vector. Then,the recombinant plasimids were transformed to E. coli BL21. After induced by IPTG,recombinant protein was purified by Affinity chromatography. Furtherly,its allergenicity was identified by Western blot,the potential B cell epitopes was analyzed through DNAStar and build the evolutionary trees by MEGA5. 05. Results: The recombinant protein of Profilin was successfully expressed and purified by affinity chromatography. Besides,the protein contains a high IgE-binding activity with IgE existing in serum of patients allergic to silkworm. Conclusion: The recombinant proflilin has IgE-binding activity, and it is meaningful for fundamental research and specific diagnosis studies of allergic diseases caused by silkworm.

Application of continuous subcutaneous insulin infusion in desensitization for allergy to recombinant human insulin / 中华临床营养杂志

Objective To evaluate the values of continuous subcutaneous insulin/rapid insulin analoguc infusion in desensitization for allergy to recombinant human insulin. Methods Two patients allergic to recombinant human insulin received desensitization therapy by continuous subcutaneous insulin lispro infusion. The diluted insulin lispro solution was pumped with initial basal rate of O. O1 U/h, and the basal rate and insulin lispro concentration increased gradually until the insulin dosage for clinical treatment was reached. After that, continuous subcutaneous insulin lispro infusion was replaced by regimen of insulin lispro subcutaneous injection plus oral hypoglycemic agents. Results Local wheals were not observed in both two patients during continuous subcutaneous insulin lispro infusion or during bolus subcutaneous injection of insulin lispro after desensitization. Conclusion The desensitization therapy by continuous subcutaneous insulin/rapid insulin analogue infusion can be applied for allergy to recombinant human insulin.