Clinical application of non-invasive prenatal testing for twin pregnancies / 中华医学遗传学杂志

OBJECTIVE@#To evaluate the feasibility of non-invasive prenatal testing (NIPT) for the screening of fetal chromosome aneuploidies in twin pregnancies.@*METHODS@#A total of 2 745 women with twin-pregnancies were subjected for NIPT screening. Chromosomal karyotyping and chromosomal microarray analysis (CMA) were carried out on amniotic fluid samples from those with a high risk for fetal chromosome aneuploidies, and the diagnosis and pregnancy outcome were followed up. The sensitivity, specificity, positive predictive value and false positive rate of the NIPT were calculated.@*RESULTS@#Compared with other chromosomal abnormalities, NIPT had a higher efficacy for trisomy 21 and sex chromosomal aneuploidy (SCA) in twin pregnancies (with sensitivity being 100%, 100%, and specificity being 99.93%, 99.9%, respectively). It is difficult to evaluate the efficacy for trisomies 18 and 13 due to the limited data. For chromosome microdeletions and microduplications spanning 15 ~ 21 Mb, NIPT also had a certain detection rate. Compared with women with natural conception, NIPT had a higher detection rate for those with twin pregnancies by assisted reproduction (P < 0.05).@*CONCLUSION@#It is feasible to use NIPT for the detection of chromosome aneuploidies in women with twin pregnancies.

Study of GCN repeats of PHOX2B gene among individuals from southwest China and diagnosis of two patients with Congenital central hypoventilation syndrome / 中华医学遗传学杂志

OBJECTIVE@#To study the trinucleotide repeats of GCN (GCA, GCT, GCC, GCG) encoding Alanine in exon 3 of the PHOX2B gene among healthy individuals from southwest China and two patients with Congenital central hypoventilation syndrome (CCHS).@*METHODS@#The number and sequence of the GCN repeats of the PHOX2B gene were analyzed by capillary electrophoresis, Sanger sequencing and cloning sequencing of 518 healthy individuals and two newborns with CCHS, respectively.@*RESULTS@#Among the 1036 alleles of the 518 healthy individuals, five alleles were identified, including (GCN)7, (GCN)13, (GCN)14, (GCN)15 and (GCN)20. The frequency of the (GCN)20 allele was the highest (94.79%). And five genotypes were identified, which included (GCN)7/(GCN)20, (GCN)13/(GCN)20, (GCN)14/(GCN)20, (GCN)15/(GCN)20, (GCN)20/(GCN)20. The homozygous genotypes were all (GCN)20/(GCN)20, and the carrier rate was 89.58%. Four GCN sequences of the (GCN)20 homozygous genotypes were identified among the 464 healthy individuals. The GCN repeat numbers in the exon 3 of the PHOX2B gene showed no significant difference between the expected and observed values, and had fulfilled the,Hardy-Weinberg equilibrium. The genotypes of the two CCHS patients were (GCN)20/(GCN)25 and (GCN)20/(GCN)30, respectively.@*CONCLUSION@#It is important to determine the GCN repeats and genotypic data of the exon 3 of the PHOX2B gene among the healthy individuals. The number of GCN repeats in 518 healthy individuals was all below 20. The selection of appropriate methods can accurately detect the polyalanine repeat mutations (PARMs) of the PHOX2B gene, which is conducive to the early diagnosis, intervention and treatment of CCHS.

Application of AI diagnostic system in the evaluation of CHD patients in high-altitude areas / 重庆医学

Objective To explore the application of diagnostic system with artificial intelligence(AI)in the evaluation of patients with coronary heart disease(CHD)at high altitude.Methods A total of 318 pa-tients underwent coronary CT angiography(CTA)at the hospital from January to December 2022 were pro-spectively collected.According to the altitude gradient,the patients were divided into the 2 000-3 000 m group and>3 000 m group.Coronary angiography(CAG)was used as the gold standard to verify the diag-nostic performance of AI diagnostic system.Coronary artery diagnosis system with AI technology and CT de-rived fractional flow reserve(CT-FFR)measurement system were used to evaluate the plaque structure char-acteristics and hemodynamic changes in the two groups of patients.Results Calcified plaques and vulnerable plaques in the>3 000 m group were more than those in the 2 000-3 000 m group(χ2=3.976,6.482,P= 0.046,0.011).The incidence of multi-vessel coronary artery disease,moderate stenosis,severe stenosis and complete occlusion in the>3 000 m group was higher than that in the 2 000-3 000 m group,and the inci-dence of single-vessel coronary artery disease and mild stenosis in the 2 000-3 000 m group was higher than that in the>3 000 m group(P<0.05).The incidence of CT-FFR≤0.80 and<0.70 in the>3 000 m group was higher than that in the 2 000-3 000 m group(χ2=4.782,28.118,P=0.029,<0.001).The comparison with the gold standard showed that this method has high sensitivity,specificity,and diagnostic consistency(P<0.001).Conclusion The coronary diagnosis system with AI technology has certain value in the system-atic evaluation of coronary artery characteristics and hemodynamic changes in CHD patients at high altitude.

Research progress in epidemic trend of infectious diarrhea / 中华微生物学和免疫学杂志

Infectious diarrhea is a gastrointestinal infectious disease caused by a wide range of pathogens and found throughout the world. It is one of the most important public health problems in the world and the second leading cause of death among children under five years of age. The pathogens of infectious diarrhea include viral diarrhea pathogens, bacterial diarrhea pathogens, and parasites. Viruses are the most frequent pathogens, mainly including norovirus, rotavirus, astrovirus and sapovirus. The most frequently identified organisms causing bacterial diarrhea are diarrheagenic Escherichia coli, Salmonella, Shigella, Vibrio parahaemolyticus and Campylobacter. This paper provides an overview of the epidemiological trends and changes in the pathogen spectrum of infectious diarrhea for better understanding the distribution and epidemiological features of infectious diarrhea in China, and hopes to provide reference for developing prevention and control strategies and reducing the disease burden.

Effect of sling massage exercise on postpartum pelvic girdle pain / 中国康复理论与实践

ObjectiveTo investigate the effect of the sling massage exercise on postpartum pelvic girdle pain (PPGP). MethodsFrom March, 2022 to May, 2023, 56 patients with PPGP in Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into control group (n = 28) and observation group (n = 28). Both groups received routine physical therapy and healthy education, while the control group received exercise therapy and the observation group received sling massage exercise, for six weeks. They were assessed with Visual Analog Scale (VAS), Pelvic Girdle Questionnaire (PGQ) and active straight leg raise (ASLR) test before and after treatment, and measured resting and contraction thickness of transversus abdominis with ultrasound; and integrated electromyography (iEMG), root mean square (RMS), median frequency (MF) and mean power frequency (MPF) of pelvic floor muscles with surface electromyography. ResultsAfter treatment, the total effective rate was 96.43% in the observation group and 78.57% in the control group (Z = 2.728, P < 0.05). All the indexes improved in both groups (|t| > 2.080, P < 0.05) except resting thickness of transverse abdominis muscle, and improved more in the observation group than in the control group (|t| > 2.161, P < 0.05). ConclusionThe sling massage exercise can alleviate pain, enhance the stability of the core muscle group, and improve load transfer and quality of life, better than exercise therapy.

Evaluation of effectiveness of allergen subcutaneous immunotherapy in children with asthma / 国际儿科学杂志

Bronchial asthma(asthma)is a common chronic airway inflammatory disease in children, most of which are allergic asthma.Allergen immunotherapy can change the natural course of asthma, and has certain efficacy in controlling asthma symptoms, reducing airway hyperresponsiveness and reducing the use of control drugs.It is the treatment for the cause.The most common allergen immunotherapy treatments are subcutaneous immunotherapy and sublingual immunotherapy.This article reviews the effectiveness of subcutaneous immunotherapy in the treatment of children with asthma, and focuses on the effective evaluation indicators and potential biomarkers that can be used as reference in clinical practice.

A multicenter clinical study of the impact of COVID-19 pandemic on hospitalization of children with bronchiolitis / 国际儿科学杂志

Objective:In order to explore the impact of corona virus disease 2019(COVID-19)on the hospitalization of children with bronchiolitis and to improve clinicians′ understanding of the characteristics of bronchiolitis during the COVID-19 epidemic.Methods:This was a multicenter clinical study, and the data have been collected from 23 children′s medical centers in China.All the clinical data were retrospectively collected from children with bronchiolitis who were hospitalized at each study center from January 1, 2019 to December 31, 2021.The results included gender, age at hospitalization, length of stay, respiratory syncytial virus(RSV) test results, severity rating, ICU treatment, and the total number of children hospitalized with respiratory tract infection during the same period.The clinical data of children with bronchiolitis in 2019 before COVID-19 epidemic and in 2020、2021 during COVID-19 epidemic were statistically analyzed and compared.Results:According to a summary of data provided by 23 children′s medical centers, there were 4 909 cases of bronchiolitis in 2019, 2 654 cases in 2020, and 3 500 cases in 2021.Compared with 2019, the number of bronchiolitis cases decreased by 45.94% in 2020 and 28.70% in 2021.In 2019, 2020 and 2021, there were no significant differences in gender ratio, age, and duration of hospitalization.Compared with 2019, the ratio of bronchiolitis to the total number of hospitalizations for respiratory tract infection decreased significantly in 2020 and 2021( χ2=12.762, P<0.05; χ2=84.845, P<0.05).The proportion of moderate to severe bronchiolitis cases in both 2020 and 2021 was lower than that in 2019, and the difference was statistically significant ( χ2=4.054, P<0.05; χ2=8.109, P<0.05).There was no statistically significant difference in the proportion of bronchiolitis cases requiring ICU treatment between 2019, 2020, and 2021 ( χ2=1.914, P>0.05).In 2019, a total of 52.60%(2 582/4 909) of children with bronchiolitis underwent RSV pathogen testing, and among them, there were 708 cases with RSV positive, accounting for 28.00%.In 2020, 54.14%(1 437/2 654) of children with bronchiolitis underwent RSV pathogen testing, and there were 403 cases with RSV positive, accounting for 28.04%.In 2021, 66.80%(2 238/3 500) of children with bronchiolitis underwent RSV pathogen testing, and there were 935 cases with RSV positive, accounting for 41.78%.Compared with 2019 and 2020, the RSV positive rate in 2021 showed a significant increase( χ2=99.673, P<0.05; χ2=71.292, P<0.05). Conclusion:During the COVID-19 epidemic, the implementation of epidemic prevention and control measures reduced the hospitalization rate and severity of bronchiolitis, but did not reduce the positive rate of RSV detection.

Efficacy and safety of Omalizumab for the treatment of pediatric allergic asthma: a retrospective multicenter real-world study in China / 中华实用儿科临床杂志

Objective:To assess the clinical effectiveness and safety of Omalizumab for treating pediatric allergic asthma in real world in China.Methods:The clinical data of children aged 6 to 11 years with allergic asthma who received Omalizumab treatment in 17 hospitals in China between July 6, 2018 and September 30, 2020 were retrospectively analyzed.Such information as the demographic characteristics, allergic history, family history, total immunoglobulin E (IgE) levels, specific IgE levels, skin prick test, exhaled nitric oxide (FeNO) levels, eosinophil (EOS) counts, and comorbidities at baseline were collected.Descriptive analysis of the Omalizumab treatment mode was made, and the difference in the first dose, injection frequency and course of treatment between the Omalizumab treatment mode and the mode recommended in the instruction was investigated.Global Evaluation of Treatment Effectiveness (GETE) analysis was made after Omalizumab treatment.The moderate-to-severe asthma exacerbation rate, inhaled corticosteroid (ICS) dose, lung functions were compared before and after Omalizumab treatment.Changes in the Childhood Asthma Control Test (C-ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) results from baseline to 4, 8, 12, 16, 24, and 52 weeks after Omalizumab treatment were studied.The commodity improvement was assessed.The adverse event (AE) and serious adverse event (SAE) were analyzed for the evaluation of Omalizumab treatment safety.The difference in the annual rate of moderate-to-severe asthma exacerbation and ICS reduction was investigated by using t test.The significance level was set to 0.05.Other parameters were all subject to descriptive analysis.A total of 200 allergic asthma patients were enrolled, including 75.5% ( n=151) males and 24.5% ( n=49) females.The patients aged (8.20±1.81) years. Results:The median total IgE level of the 200 patients was 513.5 (24.4-11 600.0) IU/mL.Their median treatment time with Omalizumab was 112 (1-666) days.Their first dose of Omalizumab was 300 (150-600) mg.Of the 200 cases, 114 cases (57.0%) followed the first Omalizumab dosage recommended in the instruction.After 4-6 months of Omalizumab treatment, 88.5% of the patients enrolled ( n=117) responded to Omalizumab.After 4 weeks of treatment with Omalizumab, asthma was well-controlled, with an increased C-ACT score [from (22.70±3.70) points to (18.90±3.74) points at baseline]. Four-six months after Omalizumab administration, the annual rate of moderate-to-severe asthma exacerbation had a reduction of (2.00±5.68) per patient year( t=4.702 5, P<0.001), the median ICS daily dose was lowered [0 (0-240) μg vs. 160 (50-4 000) μg at baseline] ( P<0.001), the PAQLQ score was improved [(154.90±8.57) points vs. (122.80±27.15) points at baseline], and the forced expiratory volume in one second % predicted (FEV 1%pred) was increased [(92.80±10.50)% vs. (89.70±18.17)% at baseline]. In patients with available evaluations for comorbidities, including allergic rhinitis, atopic dermatitis or eczema, urticaria, allergic conjunctivitis and sinusitis, 92.8%-100.0% showed improved symptoms.A total of 124 AE were reported in 58 (29.0%) of the 200 patients, and the annual incidence was 0(0-15.1) per patient year.In 53 patients who suffered AE, 44 patients (83.0%) and 9 patients (17.0%) reported mild and moderate AE, respectively.No severe AE were observed in patients.The annual incidence of SAE was 0(0-1.9) per patient year.Most common drug-related AE were abdominal pain (2 patients, 1.0%) and fever (2 patients, 1.0%). No patient withdrew Omalizumab due to AE. Conclusions:Omalizumab shows good effectiveness and safety for the treatment of asthma in children.It can reduce the moderate-to-severe asthma exacerbation rate, reduce the ICS dose, improve asthma control levels, and improve lung functions and quality of life of patients.

Advances of n-3 polyunsaturated fatty acids in food allergy / 中华实用儿科临床杂志

Food allergy is a common allergic disease threatening the growth and development of infants and children.n-3 polyunsaturated fatty acids (PUFAs) are common nutrients in the diet, which have important structural functions and immunomodulatory effects.Their protective effect in food allergy has gradually become a potential research hotspot.This review highlights the function and immune regulation of PUFAs, the regulation of n-3 PUFAs on immunological indexes, the mechanism of food allergy, and the relationship between food allergy, and the impact of n-3 PUFAs on other allergic diseases.

Analysis of the efficacy of Dupilumab on asthma and its type 2 inflammatory comorbidities in children / 中华实用儿科临床杂志

Objective:To investigate the clinical efficacy and safety of Dupilumab on the treatment of asthma combined with atopic dermatitis (AD) and other type 2 inflammatory co-morbidities in children.Methods:Clinical data of children with asthma combined with AD, allergic rhinitis (AR) type 2 inflammatory co-morbidities who received Dupilumab treatment for 16 weeks or longer in the Pediatric Asthma and Allergy Clinic of the Second Hospital of Tianjin Medical University from April 1, 2021 to September 1, 2022 were retrospectively analyzed.The efficacy and safety of Dupilumab on the treatment of asthma combined with AD and AR in children were assessed by comparing clinical symptoms before and after 16 weeks of treatment, changes in the dosage of inhaled corticosteroids (ICS), lung function, fractional exhaled nitric oxide (FeNO), and peripheral blood eosinophil (EOS) count, and the incidence of adverse events, respectively.The correlation between the efficacy on AD, AR and asthma was assessed.Quantitative indicators that were normally distributed were compared by the paired samples t-test; otherwise, they were compared by rank- sum test.The correlation between different indicators was compared by Spearman rank correlation test. Results:(1) Ten children with asthma combined with AD, AR were recruited, including 8 males and 2 females, with the mean age of 9 (4-14) years.Three children were previously treated with subcutaneous immunotherapy (SCIT) prior to Dupilumab treatment, and 1 child was transferred to Dupilumab treatment because of a poor responsiveness to Omalizumab.(2) Improvement of asthma: after 16 weeks of treatment, asthma symptoms were well controlled in the 10 children, and none of them had acute asthma attacks.The childhood asthma control test for children and asthma control questionnaire findings were significantly improved from baseline (all P<0.05). Forced expiratory volume in the first second to the predicted value was significantly improved from baseline ( P<0.05). The dosage of ICS [all converted to Beclomethasone Dipropionate, 0 (0, 125.00) μg/d vs.400.00 (200.00, 400.00) μg/d] and FeNO level [11.00(9.00, 19.25)×10 -9vs.38.00(18.25, 56.75)×10 -9] significantly decreased from baseline (all P<0.05). Serum T-IgE testing before and after treatment were performed in 3 children, which were significantly reduced at 16 weeks of treatment compared with baseline (case 1: 2 759 kU/L vs.>5 000 kU/L; case 2: 1 432 kU/L vs.3 546 kU/L; case 3: 655 kU/L vs.1 000 kU/L, all P<0.05). (3) Improvement of asthma co-morbidities: The scoring atopic dermatitis scores, and patient-oriented eczema measure scores at each time point of follow-up decreased significantly compared with baseline (all P<0.001). The overall peripheral blood EOS count increased during the treatment period compared with baseline[1.18(0.62, 1.51)×10 9/L vs.1.01(0.54, 1.90)×10 9/L, P=0.444], although no significant difference was detected.Visual analog scale and total rhinitis medication scores decreased significantly compared with baseline (all P<0.05). (4) There was a positive correlation between baseline AD severity and the therapeutic efficacy on asthma ( r=0.697, P=0.025). (5) Safety: during the treatment, one case developed bilateral conjunctivitis and one developed bilateral bulbar conjunctival hemosiderosis, both of whom were improved after symptomatic treatment. Conclusions:Dupilumab treatment significantly improves clinical symptoms of asthma, AD and AR in children with asthma combined with AD, AR type 2 inflammatory co-morbidities, which also reduces ICS dosage, FeNO level, rhinitis medication and serum T-IgE level, and improve pulmonary function, with a good safety profile.It is a promising treatment to children with type 2 inflammatory disease who have a poor Omalizumab efficacy, and its combination with SCIT is a favorable etiologic treatment.

Progress on mechanisms and clinical application of allergen immunotherapy / 国际儿科学杂志

Allergen immunotherapy(AIT)is an effective treatment for allergic diseases that have been used for more than a century.At present, AIT is administered in two main ways: subcutaneous immunotherapy(SCIT)and sublingual immunotherapy(SLIT), which aims to induce immune tolerance to allergens and provide long-term clinical benefit to patients.The effectiveness of AIT has been confirmed and the research on its mechanism has been deepened, and AIT combined with biological agents has been widely used in clinical practice.

Application of Omalizumab combined with allergen immunotherapy in the treatment of allergic asthma in children / 中华实用儿科临床杂志

Objective:To analyze the efficacy and safety of Omalizumab (OMA) combined with allergen immunotherapy (AIT) on children with allergic asthma.Methods:Clinical data of 43 children with allergic asthma from the Second Hospital of Tianjin Medical University between August 2018 and October 2022, who were managed by OMA combined with double mite subcutaneous immunotherapy (SCIT) were retrospectively analyzed, including 30 males and 13 females with the age of 5-15 years.Twenty children with allergic asthma who were managed by the monotherapy for SCIT during the same period, including 16 males and 4 females with the age of 4-13 years were included in the control group(group1: conventional immunotherapy; group2: cluster immunotherapy). Among the 43 cases managed by OMA combined with SCIT, 20 were treated with OMA, followed by AIT (OMA-AIT group), and 23 were treated with AIT, followed by OMA (AIT-OMA group). Notably, 6 cases in AIT-OMA group who were additionally given OMA due to the difficulty in increasing doses were subgrouped in AO1 group, and 17 who were additionally given OMA due to poor control of asthma or comorbidities during the course of AIT and frequent adverse events were subgrouped in AO2 group.The number of asthma exacerbations within 1 year and during the combination therapy, the Childhood Asthma Control Test/Asthma Control Test (C-ACT/ACT) findings, the Visual Analogue Scale (VAS) for grading rhinitis, inhaled corticosteroid (ICS) dosage converted to budesonide equivalent, the Total Medication Score (TMS), comorbidities, lung function [percent-predicted forced expiratory volume in 1 second(FEV 1% pred), percent-predicted peak expiratory flow(PEF%pred), percent-predicted maximal mild-expiratory flow(MMEF%pred)], exhaled nitric oxide (FeNO), completion of the initial SCIT and adverse effects [local adverse reactions (LRs) and systemic adverse reactions (SRs)] were analyzed for assessing the efficacy and safety of OMA combined with AIT on children with allergic asthma.The t-test of two independent samples was used for comparison of measurement data that followed normal distribution.Wilcoxon′s test was used for non-normally distributed between-group comparisons.The χ2 test was used for the between-group comparison of counting data. Results:(1)Baseline comparison showed that the male ratio (17/20 cases vs.13/23 cases) and the proportion of moderate-to-severe persistent asthma (18/20 cases vs.18/23 cases) in the OMA-AIT group were significantly higher than those of the AIT-OMA group (all P<0.05). (2)Efficacy: ①In OMA-AIT group, all children reached the AIT maintenance treatment stage successfully after combination therapy.At the maintenance treatment stage, the C-ACT/ACT, VAS and TMS scores(26.0±1.25 vs.24.55±2.28, 1.50±1.24 vs.2.55±1.70, 3.60±1.47 vs.5.45±1.19)were significantly improved from baseline(all P<0.05). There were no significant differences in lung function indexes FEV 1%pred, PEF%pred, and MMEF%pred ( P>0.05), and FeNO level did not change significantly than baseline.After the combination treatment, ICS dosage significantly decreased from 240.00 (160.00, 380.00) μg/d at baseline to 140.00 (80.00, 300.00) μg/d ( P<0.05). Comorbidities, including allergic rhinitis, food allergy, atopic dermatitis and angioedema were improved.Five cases (25.00%) had once asthma exacerbation during the treatment.The duration of maintenance dose of conventional (22.70±7.10 vs.15.20±1.32) and cluster immunotherapy (13.00±4.97 vs.7.30±1.06) were longer than those of the corresponding control group(all P<0.05). ②AIT-OMA group: In AO1 group, the C-ACT/ACT score were improved from baseline( P<0.05), and VAS score, TMS score decreased from 3.00(1.75, 3.00), (4.67±1.97) points at baseline to 1.00(0, 1.00), (2.83±1.60) points by the maintenance dose in AO1 group (all P<0.05). There were no significant differences in the FEV 1%pred, PEF%pred, MMEF%pred and FeNO compared with baseline in AO1 group.ICS dosage in AO1 group significantly decreased from (180.00±78.99) μg/d at baseline to (88.88±26.23) μg/d ( P<0.05). In AO2 group, the C-ACT/ACT, VAS and TMS scores at the completion of OMA treatment[26.53±0.94 vs.25.06±2.05, 1.00 (0, 2.00) vs.2.00(2.00, 3.50), 3.41±0.94 vs.5.53±1.23]were significantly improved from baseline (all P<0.05). PEF%pred[(106.47±22.37)% vs.(94.47±26.39)%] significantly increased than baseline ( P<0.05), and the remaining lung function indexes and FeNO were not significantly improved.ICS dosage significantly decreased from 240.00(160.00, 400.00) μg/d at baseline to 80.00 (20.00, 160.00) μg/d ( P<0.05). During the combination treatment, 1 case (5.88%) had once asthma exacerbation, and all 8 cases with food allergy or atopic dermatitis or conjunctivitis had improved comorbidities.(3)Safety: adverse events during OMA injection were not reported.①In OMA-AIT group, a total of 165 OMA injections were performed in the initial treatment stage of the conventional immunotherapy group, with 13 (7.88%) reported LRs and 2 (1.21%) grade-1 SRs.A total of 143 OMA injections were performed in the initial treatment stage of the cluster immunotherapy group, with 19(13.29%) reported LRs and none of SRs.②In AIT-OMA group, there were 6 cases of adverse events in the initial treatment stage of AIT who were successfully reached the maintenance treatment stage after the addition of OMA in AO1 group.In AO2 group, children who were additionally given OMA due to adverse events in the maintenance treatment phase did not report adverse events during the combination therapy. Conclusions:OMA combined with AIT not only expands the scope of AIT, improves allergic and asthma symptoms in children, reduces the use of drugs, but also enhance the safety of AIT and compliance, reduces adverse events during AIT treatment, and even shortens the time of initial treatment.

Sensitization characteristics of ragweed pollen in Beijing area / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the sensitization characteristics of ragweed pollen in patients with allergic rhinitis（AR） and（or） allergic asthma in Beijing area, and to provide basis for the prevention and treatment of ragweed pollen sensitized population. Methods:Patients with allergic rhinitis and/or asthma from January 2017 to December 2019 in the outpatient department of Allergy Department of Beijing Shijitan Hospital were retrospectively analyzed in this study. Skin prick test（SPT） was performed with ragweed pollen allergen reagents to compare different ages, genders and respiratory diseases allergen distribution, and to observe the sensitization characteristics of its population. All of the analyses were performed using SAS software version 9.4. Results:A total of 9 727 patients were enrolled in the end. The total positive rate of ragweed pollen SPT was 45.50%（4 426/9 727）, the highest positive rate was 65.54% in 13-17 years old group; The positive rate of ragweed pollen SPT was 49.79% in allergic rhinitis combined with asthma patients, followed by 46.46% in allergic rhinitis patients, and the lowest rate was 19.42% in single allergic asthma patients. There were more females than males in both ragweed pollen sensitized and non-ragweed pollen sensitized groups（P<0.05）, and the proportion was higher in 30-39 years old than in other age groups（P<0.05）. Ragweed pollen sensitization was higher than non-ragweed pollen sensitization in the allergic rhinitis group（98.49% vs 94.76%, P<0.05）. Ragweed pollen with other summer and autumn pollen allergens in patients with positive SPT, the top three were Chenopodium pollen, Humulus pollen and Artemisia grandis pollen, with positive rates of 90.42%, 89.63% and 85.40%, respectively. Ragweed combined with other pollen sensitization accounted for 99.57%（4 407/4 426）. Allergic rhinitis was the main disease in patients sensitized with ragweed pollen alone or combined with other pollens, and there was no significant difference between the two groups（94.97% vs 98.50%, P>0.05）. Conclusion:Ragweed pollen is highly sensitized in Beijing area, single ragweed pollen sensitization is rare, often combined with multiple pollen sensitization, and allergic rhinitis is the main disease.

Research advances in the correlation between chronic subjective tinnitus and anxiety state / 临床耳鼻咽喉头颈外科杂志

Tinnitus and anxiety disorder are common clinical symptoms. Comorbidity between tinnitus and anxiety state is increasing year by year. The relationship between tinnitus and anxiety state has always been a hot topic, and this paper reviews the literature on the relationship between chronic subjective tinnitus and anxiety state in recent years.

Advance in the relationship between allergic rhinitis and ADHD in children / 国际儿科学杂志

In recent years, more and more researchers at home and abroad have realized that there is a certain relationship between allergic rhinitis(AR) and attention deficit hyperactivity disorder(ADHD) in children.Children with AR had higher ADHD related symptom scores than healthy children; ADHD children have a significantly increased risk of allergic diseases, such as asthma, eczema and atopic dermatitis.At present, it has been clear that they have the common characteristics of increasing prevalence year by year, genetic tendency, environmental and neuropsychological factors, and similar clinical manifestations.However, there is no final conclusion whether they are mutual cause and effect or comorbidities.This artide reviews the similarities between AR and ADHD in epidemiology, etiology, clinical manifestations and drug treatment, so as to further explore the correlation between AR and ADHD.

Membranous nephropathy complicated by Nocardia infection: 1 case report and literature review / 中国医师杂志

Objective:To investigate the clinical features, diagnosis and treatment of membranous nephropathy complicated with Nocardia infection, and to improve the understanding of Nocardia infection.Methods:The clinical data of a patient with membranous nephropathy complicated by Nocardia infection who were hospitalized in the department of respiratory medicine, Xiangya Hospital of Central South University were retrospectively analyzed. Using " Nocardiosis" and " membranous nephropathy" on China National Knowledge Internet (CNKI) and Wanfang databases, and using " Nocardiosis" and " menbranous nephropathy" as keywords to search the pubmed database to summarize the clinical characteristics and diagnosis and treatment points of patients with membranous nephropathy complicated by Nocardia infection.Results:This patient is a 47-year-old middle-aged male. He was admitted to the respiratory medicine department in Xiangya Hospital of Central South University due to " coughing and expectoration of sputum for 2 months, and a mass in the left lower extremity was found for 20 days" . Lung computed tomography (CT) showed that multiple nodules and changes in pleural effusion were seen in the right pleura. The sputum smear showed Gram-positive bacilli, and the smear of the mass puncture fluid of the left lower extremity showed Gram-positive bacilli (branched). After treatment with compound sulfamethoxazole, meropenem and levofloxacin successively, the phlegm was obviously improved, and the mass in the left lower extremity was basically absorbed. After 2 months of follow-up, the pleural effusion and the mass in the left lower extremity were completely absorbed. A total of 4 literatures were collected in the literature search, including 6 cases of this case, including 3 cases (50%) of Nocardia anthracis, 1 case (16.7%) of Nocardia otitis in guinea pigs, and 1 case of Nocardia stellariformis (16.7%). 1 case (16.7%) was not classified.Conclusions:Although Nocardia anthracis is rare in patients with membranous nephropathy, it can easily cause systemic disseminated infection. Therefore, in immunocompromised patients, attention should be paid to the occurrence of Nocardia infection. Co-sulfamethoxazole should be used empirically before Nocardia infection is confirmed. For sulfonamide-resistant strains, linezolid and other drugs can be used for anti-infective treatment.

Analysis of the inhalant allergen spectrum in 4 488 children with allergic rhinitis in Tianjin / 中华实用儿科临床杂志

Objective:To investigate the types and characteristics of inhalant allergens in children with allergic rhinitis (AR) in Tianjin, and to provide foundation for the prevention and treatment of AR in children.Methods:The data of 4 488 patients with AR at the Pediatric Asthma and Allergy Clinic of the Second Hospital of Tianjin Medical University from March 2016 to February 2022 were collected and analyzed retrospectively in this study.The distribution features of inhalant allergens in AR children were explored.The relationship between the positive results of inhalant allergens and the gender, age and other comorbid allergic diseases was discussed.Serum allergen-specific immunoglobulin E (sIgE) was determined using the UniCAP100 system(fluorescent enzyme-linked immunoassay). Enumeration data were expressed as the number of cases and percentage (%), and data were compared between groups by χ2 test. Results:(1)In the serum of 4 488 AR patients, 3 116 cases were positive for inhalant allergens, with a positive rate of 69.43%.There were 28.47%(887/3 116) AR patients positive for 1 allergen, 25.22%(786/3 116) positive for 2 allergens, 19.67%(613/3 116) positive for 3 allergens, and 26.64%(830/3 116) positive for 4 or more allergens.The most common inhalant allergens were moulds (45.72%, 2 052/4 488), followed by dermatophagoides farinae (34.71%, 1 558/4 488), mugwort (33.95%, 313/922), dermatophagoides pteronyssinus (31.13%, 1 397/4 488), and ragweed (30.97%, 227/733). (2)The positive rates of inhalant allergens in preschool, school age and adolescent groups were 56.15%(1 132/2 016), 79.26%(1 624/2 049) and 85.11%(360/423), respectively ( χ2=309.72, P<0.001). The most common inhalant allergen in the preschool and school age groups was moulds (40.23%, 50.85%). In the adolescent group, dermatophagoides farina (56.74%) was the predominant inhalant allergen, followed by dermatophagoides pteronyssinus (53.66%) and moulds (47.04%). There were significant differences in the types of positive inhalant allergens among the 3 groups ( χ2=466.99, P<0.001). Children in the preschool group were mostly positive for single allergens, while those in the school age and adolescent groups were positive for 4 or more inhalant allergens.(3)The positive rate of inhalant allergens in boys reached 73.28%(2 139/2 919), significantly higher than that in girls (62.40%, 979/1 569) ( χ2=58.28, P<0.001). The top 3 common inhalant allergens in boys and girls were moulds, dermatophagoides farinae, and dermatophagoides pteronyssinus.There were significant differences in the types of positive inhalant allergens between boys and girls ( χ2=75.02, P<0.001). About 20.78% of the girls were positive for single allergens, and 20.45% of the boys were positive for 4 or more allergens.(4)The AR group complicated with asthma and atopic dermatitis had the highest positive rate (79.21%)of inhalant allergens, followed by AR patients with asthma (73.67%), AR patients with atopic dermatitis (61.05%) and AR patients (57.05%) successively.There were significant differences between the groups ( χ2=178.57, P<0.001). Conclusions:The main inhalant allergens in AR children in Tianjin are moulds, dermatophagoides farinae, mugwort, dermatophagoides pteronyssinus, and ragweed.The distribution characteristics of inhalant allergens vary with the age, gender and combined allergic diseases.Allergens should be detected for AR children as soon as possible, so as to prevent AR in advance, reduce drug use, and provide evidence for specific allergen immunotherapy.

Food allergy and asthma in children / 国际儿科学杂志

Food allergy and asthma are common and increasing allergic deseases, which could coexist in one patient, complicating the disease and negatively affecting each other.Food allergies can increase the risk of asthma attacks and are one of the risk factors for developing fatal asthma attacks.Early food allergies may be a predictor of asthma to some extent.Asthma can also have a negative effect on food allergies, increasing the risk of a severe allergic reaction.Avoidance of food allergens is the prime way to avoid serious adverse reactions.

Progress of omalizumab for allergic diseases in children / 国际儿科学杂志

Allergic diseases which affect children′s health and quality of life are common diseases.Many pediatric patients′ symptoms are uncontroled after routine treatments.Omalizumab, a highly specific and binding humanized monoclonal anti-IgE antibody, has been approved as an additional treatment for moderate to severe persistent asthma and chronic spontaneous urticaria now.At the same time, there are also data confirming its efficacy and safety in other allergic diseases.This review mainly summarizes the application of omalizumab in children with allergic diseases, and focuses on the evaluation system of clinical efficacy in various diseases.Meanwhile, it discusses how the potential biomarkers predict and evaluate clinical reactions.

Combined application of anti-IgE therapy and subcutaneous immunotherapy in children with allergic asthma / 中华实用儿科临床杂志

Objective:To analyze the effects of the combined applications of Omalizumab and subcutaneous immunotherapy (SCIT) in improving clinical symptoms and immunotherapy tolerance in children with allergic asthma.Methods:A total of 9 children with asthma who received Omalizumab combined with SCIT in the Pediatrics Asthma Clinic of the Second Hospital of Tianjin Medical University from July 2018 to August 2020 were retrospectively analyzed.The symptoms of asthma, lung function, exhaled nitric oxide(FeNO), life quality scores, inhaled corticosteroids (ICS) dosage, comorbidities improvement, and adverse reactions during SCIT were analyzed and compared before and after the combined treatment.Results:After treatment, both the scores of children asthma control test/asthma control test (C-ACT/ACT) and pediatric asthma quality of life questionnaire (PAQLQ) improved in 9 patients with reduced or maintained doses of ICS.After treatment, comorbidities, including rhinitis and eczema, the scores of visual analogue scale (VAS) for rhinitis, pediatric rhinoconjunctivitis quality of life questionnaire(PRQLQ) and scoring atopic dermatitis (SCORAD) were all improved.During SCIT, all children didn′t have systemic adverse reactions, and 4 children had 1 (2 cases), 3 (1 case), and 8 (1 case) local adverse reactions, respectively.The number of rapid local adverse reactions accounts for only 2.6% (3/116 times), and the number of delayed local adverse reactions occupies 8.6% (10/116 times). Among them, the number of local adverse reactions accounts for only 2.6 % (3/116 times), and the dia-meters of swelling or induration were more than 4 cm.Conclusions:The combined applications of anti-IgE therapy and SCIT can effectively improve the symptoms and quality of life, and reduce asthma exacerbations and dosage of ICS in children with asthma.It also has certain effects on the improvement of comorbidities.At the same time, the addition of anti-IgE therapy can enhance the tolerance and compliance of SCIT.