Report on Cardiac Gross Pathologic Measurements of Sudden Cardiac Death in Adults / 法医学杂志

OBJECTIVES@#To analyze the gross pathological data of sudden cardiac death (SCD) with different causes, to provide data support for the identification of sudden cardiac death with unknown causes.@*METHODS@#A total of 167 adult SCD cases in the archive of the Forensic Expertise Institute of Nanjing Medical University from 2010 to 2020 were collected. The gross pathological data of SCD cases were summarized and the characteristics of different causes of death were statistically analyzed.@*RESULTS@#The ratio of male to female SCD cases was 3.4∶1. Coronary heart disease was the leading cause of SCD, and mainly distributed in people over 40 years old. SCD caused by myocarditis was mainly distributed in young people and the mean age of death was (34.00±9.55) years. By analyzing the differences in cardiac pathological parameters of SCD with different causes, it was found that the aortic valve circumference was significantly dilated in the SCD caused by aortic aneurysm or dissection (P<0.05). The heart weight of SCD caused by aortic aneurysm or dissection and combined factors was greater, and both pulmonary and tricuspid valvular rings were dilated in the SCD caused by combined factors in adult males (P<0.05).@*CONCLUSIONS@#Various gross pathological measures of SCD with different causes are different, which has reference value in the cause of death identification of SCD.

An analysis of circulating T lymphocytes among asthmatic children with different sensitized patterns / 中国免疫学杂志

Objective:To investigate the difference in circulating T lymphocyte subsets among asthmatic children with different sensitized patterns.Methods:A total of 374 asthmatic children were enrolled in present study,and the sensitized patters were identified using skin prick testing.The numbers of circulating T cells (CD3+,CD19+),CD4+T cells (CD3+,CD4+),CD8+ T cells (CD3 + CD8 +),Tregs(CD4+ CD25+ FOXP3+),Th1 (CD4+IFN-γ+T),Th2 (CD4+ IL-4+ T)and Th17 cells(CD4+ IL-17+ T)in peripheral blood were measured by flow cytometry.Results:According to positive skin responses detected by SPT,patients with asthma were divided into three groups:un-sensitized asthma group,mono-sensitive asthma group and poly-sensitized asthma group.Compared with healthy controls,there were significant variations in CD4+ T cells and CD8+ T cells and CD4/CD8 ratio,Th1 cells and Th2 cells and Th1/Th2 ratio,Tregs,Th17 cells,Tregs/Th17 ratio (all P ＜ 0.05).A further pairwise comparison indicated that the statistically significant difference in Tregs,Th17 cells and Tregs/Th17 were found among un-sensitized asthma group,mono-sensitive asthma group and poly-sensitized asthma group(all P＜0.05).According to the type of allergens detected by SPT,the asthmatic patients were divided into the dust mite group,mould group,animal dander group,pollen group and other groups.Compared with healthy controls,there were significant variations in CD4+ T cells and CD8+ T cells and CD4/CD8 ratio,Th1 cells and Th2 cells and Th1/Th2 ratio,Tregs,Th17 cells,Tregs/Th17 ratio(all P＜0.05).Similarly,a pairwise comparison indicated that the numbers of Th1 cells,T h2 cells,Th2 cells,Th1/Th2 ratios,Tregs,Th17 cells and Tregs/Th17 ratios were found significant among these 5 groups(all P＜0.05).Conclusion:The finding highlights the importance of paying attention to the differences in the distribution of T lymphocyte subgroups among asthmatic patients with different sensitization patterns.

Distribution characteristics of serum specific IgE for inhaled allergens in children with different airway allergic diseases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the distribution characteristics of serum specific IgE (sIgE) for inhaled allergens in children with different airway allergic diseases.</p><p><b>METHODS</b>Fluorescent enzyme-linked immunosorbent assay on the UniCAP250 system was performed to measure serum sIgE for 9 common inhaled allergens in 256 children aged 3-14 years with different airway allergic diseases. According to the clinical diagnosis, these children were divided into rhinitis group (37 children with allergic rhinitis), asthma group (82 children with bronchial asthma), and rhinitis-asthma group (137 children with allergic rhinitis complicated by bronchial asthma). The three groups were compared in terms of the detection rates of 9 inhaled allergens, sensitization level, and number of allergens.</p><p><b>RESULTS</b>The detection rate of serum sIgE for inhaled allergens was 57.3% (47/82) in the asthma group, 86.5% (32/37) in the rhinitis group, and 82.5% (113/137) in the rhinitis-asthma group (P<0.05). The most common allergen in the asthma, rhinitis, and the rhinitis-asthma groups was mould fungi (32.9%, 54.1%, and 48.9% respectively), followed by dust mites (30.5%, 45.9%, and 46.0% respectively), pollen (26.8%, 35.1%, and 32.8% respectively), pets (12.2%, 27.0%, and 18.2% respectively), and cockroach (9.8%, 5.4%, and 5.8% respectively). The rhinitis group and the rhinitis-asthma group had a significantly higher detection rate of mould fungi (mx2) than the asthma group (P<0.0166). There were no significant differences in the sensitization level of 9 allergens and number of allergens between the three groups.</p><p><b>CONCLUSIONS</b>In children with either bronchial asthma, allergic rhinitis, or bronchial asthma complicated by allergic rhinitis, the three most common inhaled allergens are mould fungi, dust mites, and pollens. Compared with bronchial asthma, allergic rhinitis may be more closely associated with sensitization by mould fungi. The three common airway allergic diseases have similar distribution characteristics of inhaled allergens.</p>

Quality control for maximal expiratory flow-volume curve as a pulmonary function test in school-age children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To assess the quality control for the maximal expiratory flow-volume (MEFV) curve in school-age children.</p><p><b>METHODS</b>Eight hundred and sixty-two children who had two or more MEFV manoeuvres were classified into ≥6-year-old (n=379), ≥8-year-old (n=210), ≥10-year-old (n=64), and 12-17-year-old groups (n=109). The parameters of quality control and concordance with quality control criteria for MEFV were compared between the two groups. In addition, patients who were diagnosed with asthma were classified into two groups, one with normal pulmonary function (n=155) and the other with abnormal pulmonary function (n=62), based on the results of spirometry. Differences in the parameters of quality control for spirometry were compared between the two groups.</p><p><b>RESULTS</b>Eight hundred and sixty-two children underwent 2 367 MEFV manoeuvres, 97.8% of which met the start of test criterion for backward extrapolated volume (VBE) of less than 0.15 L, with the highest concordance in the ≥6-year-old group and the lowest concordance in the 12-17-year-old group. Three hundred and eighty-one children (44.2%) met the end of test criterion for forced expiratory time (FET) and the concordance in children over 10 years of age was lower than that in children under 10 years of age (P<0.05). Differences in two best forced expiratory volume in first second (FEV1) and forced vital capacity (FVC) manoeuvres were within 150 mL in 91.9% and 84.8%, respectively, of the children. The parameters of quality control for spirometry were better for asthmatic children with abnormal pulmonary function compared with asthmatic children with normal pulmonary function (P<0.05).</p><p><b>CONCLUSIONS</b>Concordance with the start of test criteria and the manoeuvre repeatability criteria is high, whereas the concordance with the end of test criteria is low. It is suggested that the concordance with the FET criteria should be improved.</p>

A comparision of the effects of subcutaneous and sublingual immunotherapy on immunological responses in children with asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the difference in the effects of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) on immunological responses in children with asthma.</p><p><b>METHODS</b>A total of 86 children with asthma caused by dust mites were enrolled and divided into a SLIT group (n=29), a SCIT group (n=13), a group receiving complete SCIT course (complete SCIT group; n=14), and a group receiving conventional medication (control group, n=30). Peripheral blood mononuclear cells were isolated and stimulated with house dust mite extract for 48 hours in vitro, and the percentage of regulatory T cells (Treg%) in CD4+ T cells was measured by flow cytometry. Analysis of variance with repeated measures was applied to compare the changes in humoral immunological indices and therapeutic effects in the SCIT and SLIT groups before treatment and after 6 and 12 months of treatment.</p><p><b>RESULTS</b>Before antigenic stimulation, Treg% in CD4(+) T cells in the SCIT group was significantly higher than that in the SLIT and control groups; after antigenic stimulation was given, Treg% in the four groups decreased significantly. After 6 and 12 months of immunotherapy, the SCIT group had significant changes in serum sIgE and sIgG4 levels, while the SLIT group only showed a significant change in serum sIgE level.</p><p><b>CONCLUSIONS</b>Temporal difference exists in different immunotherapies to cause immunological responses in children with asthma, and immunological responses induced by SCIT may occur earlier.</p>