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Objective:To analyze the factors related to the control and stability of asthma and allergic rhinitis in children.Methods:Children with airway allergic diseases who visited Department of Allergy and Department of Otorhinolaryngology of Beijing Children′s Hospital from April to December 2015 were enrolled in the prospective study. Patients underwent baseline assessment and regular management every three months. The stability of disease control was evaluated after one year of treatment; according to the control level, children were divided into stable control group and unstable group. The gender, age, history of asthma, allergic rhinitis and eczema, family history, allergen sensitization, pulmonary function, fractional exhaled nitric oxide were compared between the two group.Results:A total of 147 children with airway allergic diseases were included and 106 children were followed up for 12 months. According to the control level at 12 months, there were 60 cases(56.6%)in stable group and 46 cases(43.4%)in unstable group. The proportion of children with eczema history in the unstable group was significantly higher than that in the stable group [88.9%(32/46) vs. 71.7%(43/60), χ 2=3.91, P=0.048]. The allergic rhinitis VAS in the unstable group was significantly higher than that in the stable group at the baseline [(4.7±1.9) vs.(3.7±2.3), t=2.12, P=0.037]. The serum T-IgE level in unstable group was significantly higher than that in the stable group at the baseline [269.0(163.0, 578.5)kU/L vs. 195.5(69.7, 420.8)kU/L, Z=2.01, P=0.044]. The sensitivity rate to dust mite in the unstable group was significantly higher than that in the stable group [76.1%(35/46) vs.55.0%(33/60), χ 2=5.19, P=0.025]. The improvement rate of forced expiratory volume in one second (FEV 1) in the unstable group was significantly higher than that in the stable group[(14.2±11.5) vs.(7.3±5.9), t=2.42, P=0.018]. Conclusion:Eczema history, the severity of allergic rhinitis, serum T-IgE level, atopy and pulmonary physiology are associated with unstable status of airway allergic diseases in children.
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Objective:To know the exercise status of asthmatic in school-age, and to identify possible influen-cing factors.Methods:School-age children with a firm diagnosis of asthma were continuously included in Asthma Clinic of Allergy Department, Children′s Hospital Affiliated to Capital Medical University from January 2016 to January 2017.Patients who complain any symptoms during or after exercise with or without exercise limitation were assigned to the abnormal exercise group (ANE), and children who stated no symptoms and exercise limitation were defined as normal exercise group (NE), correspondingly.These data include age, gender, length of recurrent wheezing history, duration of treatment with inhaled corticosteroids (ICS), asthma control status, body mass index (BMI), pulmonary function parameters by spirometry and plethysmography that were collected and analyzed.Results:A total of 194 cases were included: 135 cases (69.6%) were well controlled, 39 cases (20.1%) were partially controlled, and 20 cases (10.3%) were uncontrolled.Totally, 95 cases (49.0%) were distributed in ANE group, while 99 cases (51.0%) were in NE group.Meanwhile, 111 patients (57.2%) had normal BMI, 32 patients (16.5%) were overweight, and 51 patients (26.3%) were obese.In the Logistic regression model of all cases, the worse asthma control level (partially controlled OR=4.77, 95% CI: 2.07-11.00, P<0.001, uncontrolled OR=10.02, 95% CI: 2.70-37.22, P=0.001) and higher BMI ( OR=1.15, 95% CI: 1.06-1.25, P=0.001) were closely associated with the significantly increased risk of exercise abnormality.Among the patients with normal BMI, ANE group had more cases with hyperinflation than normal exercise group (43.8% vs.19.0%, P=0.005). Conclusions:The results suggested that poor asthma control status and overweight/obesity are risk factors for exercise limitation, and excessive lung inflation may also affect exercise in children with asthma.
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Objective@#To analyze the dynamic changes in the expression and function of peripheral type Ⅱ innate lymphoid cell (ILC2) subpopulation and the activity of signal transducers and activators of transcription (STAT6) in children with hay fever during pollen season.@*Methods@#A total of 10 patients with hay fever, 10 patients with house dust mite (HDM)-sensitized asthma and 12 healthy controls (HC) were enrolled in this study. Changes in peripheral ILC2 and the intracellular expression of Th2-related cytokines were detected by flow cytometry during and outside the pollen season. Peripheral Lin- cell population was isolated from each group and cultured with the presence of IL-25 or IL-33 for 7 d. The concentrations of IL-5 and IL-13 in culture supernatants were measured by ELISA. Expression of phospho-STAT6 at protein level was quantified by Western blot.@*Results@#Within the pollen season, the percentage of peripheral ILC2 cells was significantly higher in children with hay fever [(23.09±7.86)%] than in children with HDM-sensitized asthma [(6.84±3.85)%, P<0.05] and healthy children[(1.69±0.87)%, P<0.05]. In the non-pollen season, the peripheral ILC2 cells in children with hay fever presented a decreasing trend [(11.30±2.45)%], but was still higher than that in HDM-sensitized asthmatics [(3.76±1.96)%, P<0.05] and HC [(1.32±0.91)%, P<0.05] at the same time point. Moreover, peripheral IL-13+ ILC2 cells in children with hay fever [(6.94±3.16)% vs(4.17±1.98)%, P<0.05] and in HDM-sensitized asthmatics [(1.89±0.70)% vs(1.44±0.55)%, P<0.05] during the pollen season were significantly higher than those in the non-pollen season. After the in vitro stimulation with IL25 or IL-33, the levels of IL-5 and IL-13 in culture supernatants were both increased in children with hay fever and HDM-sensitized asthmatics, and a synergistic action was observed when IL25 and IL-33 were used in combination. Meanwhile, the protein level of phospho-STAT4 in Lin- cells was significantly up-regulated in the hay fever group after stimulation with IL25 and IL-33.@*Conclusions@#During the pollen season, the abnormal number and function of ILC2 subpopulation in children with hay fever might be another cause of the occurrence of clinical symptoms in a short period of time or acute exacerbation.
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Objective To analyze the dynamic changes in the expression and function of peripher-al typeⅡinnate lymphoid cell (ILC2) subpopulation and the activity of signal transducers and activators of transcription (STAT6) in children with hay fever during pollen season. Methods A total of 10 patients with hay fever, 10 patients with house dust mite ( HDM)-sensitized asthma and 12 healthy controls ( HC) were enrolled in this study. Changes in peripheral ILC2 and the intracellular expression of Th2-related cyto-kines were detected by flow cytometry during and outside the pollen season. Peripheral Lin- cell population was isolated from each group and cultured with the presence of IL-25 or IL-33 for 7 d. The concentrations of IL-5 and IL-13 in culture supernatants were measured by ELISA. Expression of phospho-STAT6 at protein level was quantified by Western blot. Results Within the pollen season, the percentage of peripheral ILC2 cells was significantly higher in children with hay fever [(23. 09±7. 86)％] than in children with HDM-sen-sitized asthma [(6. 84±3. 85)％, P<0. 05] and healthy children[(1. 69±0. 87)％, P<0. 05]. In the non-pollen season, the peripheral ILC2 cells in children with hay fever presented a decreasing trend [(11. 30±2. 45)％], but was still higher than that in HDM-sensitized asthmatics [(3. 76±1. 96)％, P<0. 05] and HC [(1. 32±0. 91)％, P<0. 05] at the same time point. Moreover, peripheral IL-13+ILC2 cells in children with hay fever [(6. 94±3. 16)％ vs(4. 17±1. 98)％, P<0. 05] and in HDM-sensitized asthmatics [(1. 89 ±0. 70)％ vs(1. 44±0. 55)％, P<0. 05] during the pollen season were significantly higher than those in the non-pollen season. After the in vitro stimulation with IL25 or IL-33, the levels of IL-5 and IL-13 in culture supernatants were both increased in children with hay fever and HDM-sensitized asthmatics, and a synergis-tic action was observed when IL25 and IL-33 were used in combination. Meanwhile, the protein level of phospho-STAT4 in Lin-cells was significantly up-regulated in the hay fever group after stimulation with IL25 and IL-33. Conclusions During the pollen season, the abnormal number and function of ILC2 subpopula-tion in children with hay fever might be another cause of the occurrence of clinical symptoms in a short period of time or acute exacerbation.
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Objective To analyze the effects on control rate and the outcome of pulmonary function in children with bronchial asthma (abbreviated asthma) who were received the two years standardized treatment and management,and to explore the sensitive parameters of control effects in children with asthma.Methods Using the retrospective analysis,asthmatic children were selected from January 2014 to January 2015 in Beijing Children's Hospital,allergy and asthma outpatient clinics.All the patients were received asthma control treatment and management according to GINA guidelines (2014 version).They were assessed on asthma control level at one year and two years follow up visits respectively and their pulmonary function were evaluated at the same time.According to response status to therapy and adjustment of step up and down,children were divided into two groups,the stable control group and the difficult to control group.The parameters of sex,age,asthma,combined with rhinitis,allergen sensitization and pulmonary function were compared between the two groups.Results A total of 149 patients were enrolled in this study.The treatment levels were 20.2％,67.1％ and 12.7％ respectively at grade 2,grade 3 and ≥ 4 grade.After Treatment management for one year and two years,the asthma control level were assessed as good control was 81.8％ and 83.2％ respectively (P ＜ 0.05) Each parameter of pulmonary function excepted FEV1/FVC at the one year visit point after treatment and management was significantly higher than that at enrollment (P ＜ 0.05).After two years of treatment and management,PEF％ pred and FEF25 ％ pred was higher than that at first follow up visit (P ＜ 0.05).There were no significantly different on the distribution of sex,age,course of asthma,allergic rhinitis,allergen sensitization and initial control treatment level between the stable control and the difficult to control groups.Asthma control stability status assessment and analysis at the one year follow up visits showed that PEF％ pred was significantly higher in the group of stable control than that in group of difficult to control (97.3 ± 14.3 vs 93.1 ± 15.1,P ＜ 0.05).Asthma control stability starus assessment and analysis at two years follow up visits showed that the positive rate of allergen sensitization was significantly lower in the group of stable control than that in group of difficult to control (P ＜ 0.05),while FEV1/FVC was significantly higher in the group of stable control than that in group of difficult to control (81.0 ± 9.47vs77.4 ± 8.95,P＜0.05).Conclusion School age children asthma control level were improved with longer time regular treatment and management as well as the pulmonary function improvement.Multiple allergenic sensitization and lower PEF％ pred value and FEV1/FVC are suggestive parameters for children with difficult to control asthma.
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More than 7000 single gene diseases have been identified and most of them lack effective treatment. As an early form of prenatal diagnosis, preimplantation genetic diagnosis (PGD) is a combination of in vitro fertilization and genetic diagnosis. PGD has been applied in clinics for more than 20 years to avoid the transmission of genetic defects through analysis of embryos at early stages of development. In this paper, a review for the recent advances in PGD for single gene diseases is provided.
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Animais , Feminino , Humanos , Gravidez , Fertilização in vitro , Doenças Genéticas Inatas , Diagnóstico , Embriologia , Genética , Diagnóstico Pré-Implantação , Métodos , Diagnóstico Pré-Natal , MétodosRESUMO
Objective To investigate the levels and significance of Th17 cells and regulatory T cells (Treg) in peripheral blood of children with allergic rhinitis during pollen and non-pollen seasons.Methods Thirteen children with hay fever, 10 children with house dust mite(HDM)-allergic asthma and 10 healthy children were recruited into this study.Percentages of Th17 and Treg cells were detected by flow cytometry.Levels of IL-17, IL-10 and TGF-β in cell culture supernatants were measured by ELISA.Results (1) The percentages of Th17 cells in children with allergic rhinitis [(3.4±2.4)%] were significantly higher than those in HDM-allergic asthmatics [(2.1±1.6)%] and those in healthy children [(0.5±0.3)%] during pollen season (both P<0.05).The levels of Treg cells in allergic rhinitis group [(2.1±1.3)%] and in HDM-allergic asthma group [(3.6±1.9)%] were significantly lower than those in healthy control group [(5.5±2.8)%] (both P<0.05).The levels of Th17 cells [(3.0±1.9)% vs (3.4±2.4)%, P<0.05] and ratios of Th17/Treg cells [(1.4±1.0)% vs (1.7±1.5)%, P<0.05] in children with allergic rhinitis were significantly decreased during non-pollen season as compared with those during pollen season, but the levels of Treg cells were up-regulated [(2.4±1.6)% vs (2.1±1.3)%, P<0.05].(2) Correlation analysis revealed that the ratios of Th17/Treg cells were positively correlated with the concentrations of FeNO (fractional concentration of exhaled NO) (r=0.321, P<0.05) and the counts of circulating eosinophils (r=0.198, P<0.05) in children with allergic rhinitis during pollen season.Conclusion The imbalanced Th17 and Treg cells in children with allergic rhinitis during pollen season might play a vital role in the regulation of allergic airway inflammation.
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Pulmonary function testing (PFT) is a widely used method in early screening, severity evaluating and outcome predicting of lung diseases. In the practice of standardized training of pulmonary function tests, through the problem-based theory teaching and participative teaching and so on, we made the lung function inspection personnel to realize the examination operation essentials, and through situational teaching, we also cultivated the inspection personnel to master the communication skills with the children, so as to improve their professional quality, and ensure the effectiveness of the quality control of pulmonary function.
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Objective To evaluate surgical complications and outcomes based on prostate size in patients with benign prostatic hyperplasia (BPH) treated with plasmakinetic enucleation of prostate (PKEP).Methods A retrospective review was conducted of PKEP performed in 326 patients with BPH.According to the prostate size on preoperative transrectal ultrasonography measurement,patients were divided into three groups:groupl:＜40ml (n =92),group2:40～80ml (n =155),and group3:＞80ml (n =79).Intraoperative and perioperative parameters were evaluated.Patient perioperative data and postoperative outcomes were compared.Patients were followed up at 1,3,6 and 12 months after surgery.Early and late complications were recorded.Results There were significant differences among three groups regarding the mean operative time (P ＜ 0.01) and the mean resected tissue weight (P ＜ 0.01).However,enucleation efficiency (P ＜ 0.01) in gm tissue per minute increased significantly as prostate size increased.Mean hemoglobin decrease (P ＞0.05),mean serum sodium decrease (P ＞0.05),mean postoperative irrigation time (P ＞ 0.05),mean catheter time (P ＞ 0.05) and mean hospital stay (P ＞0.05) did not differ significantly among three groups.Three groups had a similar and significant postoperative improvement in international prostate symptom score (IPSS),quality of life (QOL),maximum urine rate (Qmax),and post-void residual urine volume(PVR) independent of prostate size (P ＜ 0.01),but no significant difference was found among three groups during 1,3,6 and 12-month follow-up (P ＞ 0.05).Perioperative and postoperative complications did not depend on prostate size (P ＞ 0.05).Conchsions Although patients with a larger BPH required significantly longer operation time in PKEP,prostate size did not affect perioperative and postoperative complications or micturition improvement.