Doxorubicin Hydrochloride Liposome-Based CHOP Regimen in the Initial Treatment of Elderly Patients with Diffuse Large B-Cell Lymphoma: A Retrospective Study / 中国实验血液学杂志

OBJECTIVE@#To evaluate the efficacy and safety of CHOP regimen based on doxorubicin hydrochloride liposome in the initial treatment of elderly patients with diffuse large B-cell lymphoma (DLBCL).@*METHODS@#Thirty-one patients with DLBCL treated from January 1, 2012 to December 31, 2019 were analyzed retrospectively, their median age was 83 (71-95) years old, and all of them were in Ⅲ-Ⅳ stage, including 17 cases who had international prognostic index (IPI) ≥ 3. The patients were treated with R-CHOP and CHOP regimens based on doxorubicin hydrochloride liposome. The efficacy and safety were evaluated during and after treatment.@*RESULTS@#A total of 219 chemotherapy cycles and 7 median cycles were performed in 31 patients. The overall response (OR) rate and complete remission (CR) rate was 80.7% (25/31) and 61.3% (19/31), respectively, as well as 2 cases (6.5%) stable, 4 cases (12.9%) progressive. The main toxicities were as follows: the incidence of grade Ⅲ -Ⅳ neutropenia was 29% (9/31); two patients (6.5%) developed degree Ⅰ-Ⅱ cardiac events, which were characterized by new degree Ⅰ atrioventricular block; there were no cardiac events requiring emergency treatment and discontinuation of chemotherapy. The 1-year, 2-year and 3-year overall survival rate was 83.9%, 77.4% and 61.3%, respectively. The 1-year, 2-year and 3-year progression-free survival rate was 77.4%, 64.5% and 61.3%, respectively.@*CONCLUSION@#The chemotherapy regimen based on doxorubicin hydrochloride liposome has better efficacy and higher cardiac safety for elderly patients with DLBCL.

Agreement of Spatiotemporal Gait Characteristics between Gaitboter Gait Analysis System and Noraxon Gait Analysis System / 中国康复理论与实践

Objective:To assess the agreement between measurements of spatiotemporal gait characteristics made with Gaitboter and Noraxon gait analysis systems. Methods:From February to April, 2019, 35 healthy adults were recruited to participate in gait analysis using Gaitboter and Noraxon gait analysis apparatuses, respectively. Stance phase, swing phase, stride length, cadence, velocity and toe out were recorded and computed. Intraclass correlation coefficients (ICC) and Bland-Altman plots were used to evaluate the agreement between the two gait analysis systems. Results:There was a good reliability in spatiotemporal gait characteristics between two gait analysis systems (ICC 0.691 to 0.835). Bland-Altman plots also showed good agreement. Conclusion:The measurements of temporal and spatial parameters with Gaitboter and Noraxon gait analysis systems yield acceptable agreement, and further study needs to be conducted on the validity of the Gaitboter gait analysis system.

Epidemiological investigation of allergic rhinitis in central cities and countrysides of Inner Mongolia region / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the prevalence of allergic rhinitis (AR) in 3 central cities (Chifeng, Hohhot, Ordos) and the surrounding rural areas of Inner Mongolia region, and to look for possible risk factors related to the disease. Methods: From March to October of 2019, a multi-stage stratified random sampling epidemiological survey was conducted in Chifeng, Hohhot, Ordos and rural areas. The AR-related factors of the population were obtained in the form of face-to-face questionnaire survey, and the skin prick test (SPT) was taken for the participants. AR disease was diagnosed according to the "Guidelines for the Diagnosis and Treatment of Allergic Rhinitis (2015, Tianjin)". The daily airborne pollen situation in the three regions was monitored during the same period. SPSS 23.0 was used to analyze all survey results. Results: A total of 6 818 questionnaires were recovered, with 6 393 valid questionnaires. The self-reported prevalence of AR was 27.72% (1 772/6 393) and the confirmed prevalence of AR was 17.10% (1 093/6 393). The prevalence of perennial AR was 1.83% (117/6 393) while the prevalence of seasonal AR was 15.27% (976/6 393). The prevalence of AR diagnosed in females was higher than that in males (19.19% vs 15.34%, χ²=16.594, P<0.001) and the prevalence of females in the two age groups of 36-45 years and 46-55 years was significantly higher than that of males (18.17% vs 9.73%, 14.13% vs 7.25%, χ2 value was 23.848, 18.772, respectively, all P<0.001). The prevalence of confirmed diagnoses in ethnic minorities was higher than that of Han nationality, and the prevalence of confirmed diagnoses in urban areas was higher than that in rural areas (23.13% vs 16.20%, 27.27% vs 9.71%, χ2 value was 24.516, 336.024, respectively, all P<0.001). The main nasal symptoms of AR patients were sneezing (91.31%), nasal congestion (85.91%) and nasal itching (85.00%). The most common concomitant disease of AR was allergic conjunctivitis (73.99%). Asthma (OR=6.629), food allergy (OR=3.236), drug allergy (OR=1.786), application of antibiotics (OR=1.553), recent home decoration (OR=2.307), and smoking (OR=1.322) were the AR related risk factors. The highest proportion of SPT positive reactions was Artemisia annua (80.15%). The peak period of clinical symptoms of AR patients in Inner Mongolia region was July to September, which was consistent with the second peak period of airborne pollen monitoring. Conclusions: The prevalence of AR in central cities and the surrounding rural areas of Inner Mongolia region is 17.10%, and Artemisia species is the most important pollen allergen in this area. History of asthma, food allergy, drug allergy, antibiotic use, home decoration and smoking history are the related risk factors for AR.

Potential Role of Interleukin-25/Interleukin-33/Thymic Stromal Lymphopoietin-Fibrocyte Axis in the Pathogenesis of Allergic Airway Diseases / 中华医学杂志(英文版)

Objective@#Allergic airway diseases (AADs) are a group of heterogeneous disease mediated by T-helper type 2 (Th2) immune response and characterized with airway inflammation and remodeling, including allergic asthma, allergic rhinitis, and chronic rhinosinusitis with allergic background. This review aimed to discuss the abnormal epithelial-mesenchymal crosstalk in the pathogenesis of AADs.@*Data Sources@#Articles referred in this review were collected from the database of PubMed published in English up to January 2018.@*Study Selection@#We had done a literature search using the following terms "allergic airway disease OR asthma OR allergic rhinitis OR chronic sinusitis AND IL-25 OR IL-33 OR thymic stromal lymphopoietin OR fibrocyte". Related original or review articles were included and carefully analyzed.@*Results@#It is now believed that abnormal epithelial-mesenchymal crosstalk underlies the pathogenesis of AADs. However, the key regulatory factors and molecular events involved in this process still remain unclear. Epithelium-derived triple cytokines, including interleukin (IL)-25, IL-33, and thymic stromal lymphopoietin (TSLP), are shown to act on various target cells and promote the Th2 immune response. Circulating fibrocyte is an important mesenchymal cell that can mediate tissue remodeling. We previously found that IL-25-circulating fibrocyte axis was significantly upregulated in patients with asthma, which may greatly contribute to asthmatic airway inflammation and remodeling.@*Conclusions@#In view of the redundancy of cytokines and "united airway" theory, we propose a new concept that IL-25/IL-33/TSLP-fibrocyte axis may play a vital role in the abnormal epithelial-mesenchymal crosstalk in some endotypes of AADs. This novel idea will guide potential new intervention schema for the common treatment of AADs sharing common pathogenesis in the future.

Discussion on the relationship between central obesity and asthma of pupils / 上海预防医学

Objective To explore the relationship between central obesity and asthma of 7-to 9-year-old pupils, and to make clear the direction of research for the next stage.Methods By cluster sampling, 6 primary schools in Shanghai were randomly selected;the parents of all the Grade One and Grade Two pupils thereof were surveyed, and physical examinations were made for these pupils.Rates were compared using the chi-square test, and the numerous factors for the central obesity and asthma of school-age children were analyzed by using the logistic regression analysis model.Results The obesity rate of these pupils was 9.40%, the rate of central obesity thereof was 16.41%, and the rate of pupils who had suffered asthma was 4.37%.The body mass index (BMI) was used in the univariate analysis to assess the nutritional status of pupils.The difference in terms of the rate of asthma between the obesity group and the non-obesity group had no statistic significance.However, the assessment based on waist circumferences showed that excess waist circumferences were related to asthma.However, multivariate regression analyses showed that masculinity, aging, little weekend sleep, good appetite, having no preference for foods, big appetite and fast eating were the risk factors for central obesity.In the model, a history of asthma was an risk factor for central obesity.Conclusion Central obesity is related to asthma for 7-to 9-year-old pupils.It is necessary to continue the follow-up study for factors influencing obesity, and to probe into the relationship between obesity and asthma, thereby providing more evidences for public health practices.

Factors affecting the safety and efficacy of peroral endoscopic myotomy for achalasia / 南方医科大学学报

<p><b>OBJECTIVE</b>To identify the factors that affect the safety and efficacy of peroral endoscopic myotomy (POEM) for treatment of achalasia.</p><p><b>METHODS</b>Data of consecutive patients undergoing POEM for confirmed achalasia between December, 2010 and December, 2015 were collected, including the procedure time, approach of tunnel entry incision, approach of myotomy, complications and follow-up data.</p><p><b>RESULTS</b>Among the total of 439 patients enrolled, the overall complication rate was 28.7% (126/439). Treatment success (Eckardt score≤3) was achieved in 94.5% of 364 patients followed up for a median of 6 months (1-48 months), and the mean score was reduced significantly from 6.7∓1.5 before treatment to 1.2∓1.1 after the treatment (P<0.05). Logistic regression revealed that the year when POEM was performed and the approach of entry incision were two significant factors contributing to complications: with the year 2015 as the reference, the odds ratio (OR) was 9.454 (95% CI: 2.499-35.76) for the years before 2011, 2.177 (95% CI: 0.794-5.974) for 2012, 3.975 (95% CI: 1.904-8.298) for 2013, and 1.079 (95% CI: 0.601-1.940) for 2014; with the longitudinal entry incision as the reference, the OR was 0.369 (95% CI: 0.165-0.824) for inverted T entry incision and 0.456 (95% CI: 0.242-0.859) for transverse entry incision. The approach of myotomy was the significantly associated with symptomatic relapse: with full-thickness myotomy combined with indwelling an anti-reflux belt as the reference, the OR was 0.363 (95% CI: 0.059-2.250) for gradual full-thickness myotomy, 2.137 (95% CI: 0.440-10.378) for circular muscle myotomy, and 4.385 (95% CI: 0.820-23.438) for circular muscle myotomy in combination with balloon shaping; the recurrence rate was 0 with a full-thickness myotomy.</p><p><b>CONCLUSION</b>The complication rates of POEM appears to decrease over time, and an inverted T entry incision is the best choice for controlling the complications. Gradual full-thickness myotomy is an excellent approach for treatment of achalasia in terms of the relapse rate, procedure time and the incidence of reflux esophagitis.</p>

Suppression of Immunotherapy on Group 2 Innate Lymphoid Cells in Allergic Rhinitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Group 2 innate lymphoid cells (ILC2s) are regarded as a novel population of lineage-negative cells that induce innate Type 2 responses by producing the critical Th2-type cytokines interleukin (IL)-5 and IL-13. ILC2s as key players in the development of allergic rhinitis (AR) have been proved, however, the effect of subcutaneous immunotherapy (SCIT) with dermatophagoides pteronyssinus extract (Der p-SCIT) on ILC2s in AR patients is not clear. This study aimed to investigate the response of ILC2s of peripheral blood in house dust mites (HDM)-sensitized Chinese patients with AR who received SCIT with Der P extract.</p><p><b>METHODS</b>Seven healthy controls without symptoms of AR who had negative reactions to any of the allergens from skin-prick testing, nine patients diagnosed with persistent AR according to the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines, and 24 AR patients who received Der p-SCIT for 1.0-3.5 years were recruited for the study. ILC2s in the peripheral blood were evaluated using flow cytometry. The severity of their symptoms of all participants was rated based on the Total 5 symptom score.</p><p><b>RESULTS</b>Among 40 participants, 9 AR patients were assigned to the untreated group, 24 AR patients receiving Der p-SCIT were assigned to the immunotherapy group, and 7 healthy controls without symptoms of AR were assigned to healthy control group. The mean Total 5 symptom score of immunotherapy group was significantly lower than that of untreated group (4.3 ± 1.4 vs. 10.1 ± 2.5, P< 0.001). Similarly, the levels of ILC2s in the peripheral blood of immunotherapy group were significantly reduced compared with that in untreated group (P < 0.001), but were not significantly different from healthy controls (P = 0.775). Further subgroup analysis based on the duration of SCIT therapy (1.0-2.0 years [SCIT1-2], 2.0-3.0 years [SCIT2-3], and 3.0-3.5 years [SCIT3-3.5]) showed that the percentage of ILC2s was not significantly different between SCIT1-2, SCIT2-3, and SCIT3-3.5groups (SCIT1-2 vs. SCIT2-3: P = 0.268; SCIT1-2vs. SCIT3-3.5: P = 0.635; and SCIT2-3 vs. SCIT3-3.5: P = 0.787).</p><p><b>CONCLUSIONS</b>The present study highlighted the suppression of Der p-SCIT on ILC2s in HDM-AR patients. ILC2s identified in peripheral blood can be used as an effective biomarker for Der p-SCIT.</p>

Correlation of TLR2 and TLR4 gene polymorphisms with the susceptibility and recurrence of condyloma acuminatum / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the correlation of the gene polymorphisms of Toll-like receptor 2 ( TLR2) and TLR4 with the susceptibility and recurrence of condyloma acuminatum (CA).</p><p><b>METHODS</b>Using Snapshot, we detected the gene polymorphisms of TLR2 597(T/C), 1350(T/C), 15607(A/G), and 2258(G/A) and TLR4 896(A/G) and 1196(C/T) in the peripheral blood of 140 CA patients and 105 HPV-negative controls. We made comparisons between the CA patients and controls as well as between the cases of recurrent CA and those of non-recurrence at 6 months after treatment.</p><p><b>RESULTS</b>There were 72, 48, and 20 cases of genotype TT, TC, and CC of TLR2 597 (T/C), respectively, in the CA patients, as compared with 71, 31, and 3 cases in the controls. The gene frequency of mutant C was 31. 43% in the patients, significantly higher than 17.62% in the controls (χ2 = 12.04, P < 0.01), and it was 38.68% in the recurrent cases, remarkably higher than 27.01% in the non-recurrent cases (χ2 = 4.16, P < 0.05). There were 74, 49, and 17 cases of genotype TT, TC, and CC of TLR2 1350( T/C), respectively, in the CA patients, as compared with 73, 29, and 3 cases in the controls. The gene frequency of mutant C was 29. 64% in the patients, significantly higher than 16. 67% in the controls (χ2 =11.05, P < 0.01), and it was 36.79% in the recurrent cases, markedly higher than 25. 29% in the non-recurrent cases (χ2 = 4.18, P < 0.05). There were 44, 66, and 30 cases of genotype AA, AG, and GG of TLR2 15607(A/G), respectively, in the CA patients, as compared with 26, 58, and 21 cases in the controls. There was no significant difference in the gene frequencies of mutant G between the two groups (χ2 = 0.33, P > 0.05). No mutant genes of TLR2 2508 (G/A) or TLR4 896(A/G) and 1196(C/ T) were detected in either the CA patients or the controls. Linkage disequilibrium analysis showed a tight linkage between TLR2 597 (T/C) and 1350(T/C) (D' = 1, r2 = 0.93).</p><p><b>CONCLUSION</b>TLR2 597(T/C) is tightly linked to 1350(T/C), which is correlated with both the susceptibility and the recurrence of condyloma acuminatum.</p>

Impaired effect of BHC80 gene knock-down on the cardiac development in zebrafish / 生理学报

The effect of BHC80 (a component of BRAF-HDAC complex) on development was not well studied, because BHC80 gene knock-out mice died in one day after birth. Interestingly, zebrafish embryos can live, even if their important organs like cardiac system has severe dysfunction, as 25%-40% O2 are supplied through their skin. Therefore, a model of BHC80 gene knock-down zebrafish embryos was established to explore the effect of BHC80 on the early embryonic development. BHC80-morpholino antisense oligonucleotides 2 (BHC80-MO2) was designed and injected into zebrafish embryos to interrupt the correct translation of BHC80 mRNA at one or two cells stage, which was proved by RT-PCR analysis. Two control groups, including non-injection group and control-MO (con-MO) injection group, and four different doses of BHC80-MO2 injection groups, including 4 ng, 6 ng, 8 ng and 10 ng per embryo were set up. The embryonic heart phenotype and cardiac function were monitored, analyzed and compared between con-MO and BHC80-MO2 groups by fluorescence microscope in vmhc:gfp transgenic zebrafish which express green fluorescent protein in ventricle. The results showed that BHC80-MO2 microinjection effectively knocked down the BHC80 gene expression, because the BHC80-MO2 group emerged a new 249 bp band which reduced 51 bp compared to 300 bp band of con-MO group in RT-PCR analysis, and the 51 bp was the extron 10. The abnormal embryo rate rose with the increase of BHC80-MO2 dosage. The proper BHC80-MO2 injection dosage was 8 ng per embryo, as minor embryos had abnormal phenotype in 4 ng and 6 ng per embryo groups and most embryos died in 10 ng per embryo group. BHC80-MO2 embryos exhibited abnormal cardiac phenotype, including imbalance of the proportion of heart ventricle to atrium, incomplete D-loop, even tubular heart, slow heart rates and cardiac dysfunction. The results from a model of BHC80 gene knock-down zebrafish embryos show that the abnormal cardiac phenotype and cardiac dysfunction of BHC80-MO2 embryos may be one of the probable reasons for the BHC80 gene knock-out mice death, which would provide a good research model to clarify the mechanism of cardiac development.

Status quo investigation on low-grade pupils vision in Zhabei District of Shanghai City / 上海预防医学

[Objective] To investigate the present status of eyesight and eye health at home in low-grade pupils in Shanghai Zhabei District ,and to provide the basis for eyesight protection . [ Methods] Random cluster sampling was done in 7 primary schools .A total of 2 598 pupils of grade 1-3 were in-cluded into our investigation .Visual examination was done for them and questionnaires approach applied to obtain information on pupils and their eye health at home . [ Results] The low vision rate of low -grade pupils in primary schools in Zhabei District was 33.4%, of whom the boys were 31.5%, and the girls 35.6%.For pupils of grade one, two and three, the low vision rates were 30.2%, 31.3%and 39.7%re-spectively, and the mild low vision rates accounted for 72.5% of the total.It took hours per day for most pupils at home to do homework or read ,and only 32.8% pupils had an interval of relaxation in 1 hour or less in doing homework and reading . [ Conclusion] The low vision rate continues to rise ,and the ad-verse eye health habits are prevalent in the pupils .Behavior intervention should be carried out as early as possible among low-grade pupils for myopia prevention .

Location of telocytes in mouse bronchial and pulmonary tissues / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the location of telocytes in pulmonary tissues.</p><p><b>METHODS</b>Electron microscopy, immunohistochemistry, primary cell culture and vital cell staining were used to identify the distribution of telocytes in mouse bronchial and pulmonary tissues.</p><p><b>RESULTS</b>Telocytes were identified in the interstitial space between bronchial cartilage (cricoid) and smooth muscle by scanning and transmission electron microscope in mouse. By transmission electron micrscope and immunohistochemistry, telocytes were found in the interstitial spaces of lung parenchyma in connection with capillaries and bronchia. Telocytes expressed CD34, c-kit and vimetin by immunohistochemistry. After isolation, cultured telocytes demonstrated typical morphological feature, i.e. cells with telopode, which was seen as luminal structures with alternating thin and thick segments under electron microscope.</p><p><b>CONCLUSION</b>Telocytes are present in the interstitial space between cricoid cartilage and smooth muscle.</p>

Long-term efficacy of Dermatophagoides pteronyssinus immunotherapy in patients with allergic rhinitis: a 3-year prospective study / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the long-term efficacy of subcutaneous immunotherapy with Dermatophagoides pteronyssinus (DerP) in patients with allergic rhinitis.</p><p><b>METHODS</b>Ninety-two patients with allergic rhinitis to DerP were randomly allocated to receive either specific immunotherapy (n = 46) or medical treatment (n = 46). Symptom and medication scores and skin response to Derp were assessed to evaluate the clinical efficacy in the baseline and after three years treatment. DerP-specific IgE and IgG4 were measured.</p><p><b>RESULTS</b>After three years treatment, the immunotherapy group showed sustained reductions in symptom scores (before treatment 9.20 [7.50;11.13], after treatment 3.32 [2.49;5.12], Z = -5.13, P < 0.05), medication scores (before treatment 0.72 [0.47;0.83], after treatment 0.31 [0.28;0.45], Z = -5.78, P < 0.05) and specific skin response to Derp (t = 6.37, P < 0.05) when compared with control group. There were no differences in the level of serum specific IgE before and after three-year treatment (before treatment 16.32 [4.34;38.65] kU/L, after treatment 15.85 [4.93;46.27] kU/L, Z = -0.84, P > 0.05), but the level of serum specific IgG4 increased significantly after one year treatment in immunotherapy group (before treatment 486 [319;1439] AU/L, after treatment 8387 [7732;16 634] AU/L, Z = -2.81, P < 0.05). After three-year treatment, 7.5% (3/40) of patients had asthma in immunotherapy group compared to 27.8% (10/36) in the control group (χ(2) = 5.50, P < 0.05), and 15.0% of the initially DerP nonsensitized patients in immunotherapy group had developed new sensitization compared to 47.2% in the control group (χ(2) = 9.32, P < 0.05).</p><p><b>CONCLUSION</b>Three years immunotherapy improves allergic rhinitis symptoms, increases the level of serum specific IgG4, reduces the development of asthma and new sensitization.</p>

Transrectal ultrasound-guided puncture and anhydrous alcohol sclerotherapy for Müllerian duct cyst / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the effect of anhydrous alcohol sclerotherapy following transrectal ultrasound-guided puncture in the treatment of Mülllerian duct cyst.</p><p><b>METHODS</b>Totally 44 patients with Müllerian duct cyst underwent transrectal ultrasound-guided puncture and sclerotherapy, 21 injected with anhydrous alcohol of half the volume of the aspirated cystic fluid followed by aspiration of all the fluid 5 minutes later (treatment group) , and the other 23 treated by cystic fluid aspiration only (control group). The clinical effects of the two methods were compared.</p><p><b>RESULTS</b>The response rate and cure rate were 80.95 and 52.38% in the treatment group, as compared with 56.52 and 26.09% in the control (P < 0.001). No adverse events were observed in either of the two groups.</p><p><b>CONCLUSION</b>Transrectal ultrasound-guided puncture and anhydrous alcohol sclerotherapy is a safe and effective approach to the treatment of Mülllerian duct cyst.</p>

Prevalence of sensitization to aeroallergens in 10 030 patients with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the main inhaled allergens in patients with allergic rhinitis.</p><p><b>METHODS</b>Forty-three standardization allergens were used to perform skin prick test in 54 813 patients with chronic rhinitis. According to different gender and age groups, 10 030 patients with allergic rhinitis were divided into eight groups. The distributions of different allergens in the eight groups were analyzed.</p><p><b>RESULTS</b>(1) The most common four allergens in male patients with allergic rhinitis were Dermatophagoides farina (Der f), Dermatophagoides pteronyssinus (Der p), Mugwort and Blaterlia Germanica. Der f, Der p, Mugwort and Chenopodium album were the most common in female patients. (2) In all groups, patients with dual positive allergens were the most common, followed by triple positive allergens and single positive allergen. (3) In single positive allergen group, the top four allergen in male 3-17 year group were Der f, Der p, Alternaria tenuis and Mugwort. In other male groups, the most common positive allergen were Der f, Der p, Mugwort and Blaterlia Germanica. Meanwhile, the top four positive allergens in female 3-17 year group were Der f, Der p, Mugwort and Alternaria tenuis, in 18-39 year group were Der f, Der P, Mugwort and Dandelion, in 40-59 year group were Der f, Der p Mugwort and mixed tree 1, in ≥60 year group were Derf, Der P, mixed animal hair and Mugwort. (4) In dual positive allergens group, the most common allergen combination was Der f+Der p, followed by Alternaria tenuis in patient of 3-17 year group. (5) In triple positive allergens group, the most common allergen combination was Der f+Der p+Blaterlia Germanica, followed by Der f+Der p+mixed animal hair.</p><p><b>CONCLUSIONS</b>Dust mites, flowers pollen, herbs, Alternaria tenuis and Blaterlia Germanica were the most common allergens in patients with allergic rhinitis. However, the frequencies of the allergens were different in different age groups.</p>

Comparative study on cluster and conventional immunotherapy with Dermatophagoides pteronyssinus in patients with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To compare the efficacy and safety of a 6-week cluster schedule of specific immunotherapy with that of a 14-week conventional schedule for the treatment of subjects with persistent allergic rhinitis (AR).</p><p><b>METHODS</b>The trial was a prospective and randomized study involving 80 patients with persistent AR, who were allergic to Dermatophagoides pteronyssinus. While 40 patients were randomly assigned to the cluster schedule reaching the maintenance dose within 6 weeks, the other 40 patients were randomly assigned to the conventional schedule reaching the maintenance dose within 14 weeks. Symptom scores and medication scores were used to evaluate the clinical efficacy. Serum specific IgG4 level was examined to mark immunologic change, adverse reactions were recorded during the treatment.</p><p><b>RESULTS</b>Cluster group achieved clinical efficacy (reducing symptom scores and medication score) and increasing serum specific IgG4 sooner (after 6 weeks treatment). During the incremental dose phase, there were 6 systemic adverse reactions (1.12% of all injection) in 3 patients in cluster group and there were 5 systemic adverse reactions (0.85% of all injection) in 3 patients in conventional group. No severe systemic reactions occurred in both group. There was no difference between the 2 groups in frequency or type of systemic reaction (χ(2) = 0.333, P > 0.05).</p><p><b>CONCLUSION</b>The cluster schedule is a safe alternative to the conventional schedule with the advantage of achieving clinical efficacy sooner.</p>

TNFα induced IL-8 production through p38 MAPK- NF-kB pathway in human hepatocellular carcinoma cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To identify the role of p38 MAPK- NF-kB signaling pathway in TNF-α induced IL-8 production in human hepatocellular carcinoma cells.</p><p><b>METHODS</b>The concentrations of IL-8 from MHCC-97H cells were measured by an enzyme-linked immunosorbent assay (ELISA). The phosphorylation of p38 MAPK was analyzed by Western blot and immunofluorescence. NF-kB p65 protein nuclear translocation was determined by non-radioactive NF-kB p50 / p65 transcription factor activity kit and immunofluorescence.</p><p><b>RESULTS</b>The IL-8 production from MHCC-97H cells challenged with TNFa significantly increased in a time-dependent (F = 144.04, P < 0.01) and dose-dependent (F = 364.14, P < 0.01) manners, as compared with those without TNFa challenge. TNFa up-regulated the phosphorylation levels of p38 MAPK and increased the translocation of NF-kB p65 protein into the nucleus, also proved by immunofluorescence staining. p38 MAPK inhibitor (SB203580) could significantly inhibit IL-8 production in a dose-dependent manners (F = 65.47, P < 0.01), and partially inhibited NF-kB p65 nuclear translocation in a dose-dependent manner (F=141.20, P < 0.05).</p><p><b>CONCLUSION</b>TNF-α could increase the production of IL-8 in MHCC-97H cells and p38 MAPK- NF-kB pathways seem to play a central role in the regulation of IL-8 production.</p>

Clinical efficacy and immunological changes in children with allergic rhinitis receiving specific immunotherapy with Dermatophagoides pteronyssinus / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and immunological changes of children receiving subcutaneous immunotherapy with Dermatophagoides pteronyssinus.</p><p><b>METHODS</b>Sixty-four children with allergic rhinitis to Dermatophagoides pteronyssinus (Der p) were randomly allocated to receive either specific immunotherapy (n = 32) or medical treatment (n = 32). Symptom and medication scores were assessed to evaluate the clinical efficacy in the baseline and after one year treatment. Total IgE, Der p-specific IgE, and specific IgG4 were measured.</p><p><b>RESULTS</b>Immunotherapy reduced the symptom (the scores reduced from 10[9;11] to 4[3;6]) and medication score (the scores reduced from 0.76[0.61;0.90] to 0.35[0.30;0.43]) in children with allergic rhinitis significantly(Z value were -4.80 and -4.74, respectively, each P < 0.01). There was a significant difference in symptom and medication scores between both groups after one year treatment (U value were 155.00 and 139.50, respectively, each P < 0.01). There were no differences in levels of serum total IgE, specific IgE before and after one year treatment, but the level of serum specific IgG4 increased significantly after one year treatment.</p><p><b>CONCLUSIONS</b>Immunotherapy with standardized extract is efficacious to treat children sensitive to Der p, allergen-specific IgG4 is significant as immunological marker to predict efficacy of immunotherapy.</p>

First 30 endobronchial ultrasound-guided transbronchial needle aspirations: a single institution's early experience / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A new technique developed in 2002, real time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), has been one of the most important tools in lymph nodes (LNs) staging before lung cancer surgery. EBUS-TBNA was introduced into China in 2008.</p><p><b>METHODS</b>Between June 2009 and October 2009, 30 patients with mediastinal/hilar lymphadenopathy and thoracic masses previously detected with CT scan underwent EBUS-TBNA without rapid onsite cytological examination.</p><p><b>RESULTS</b>From 30 patients, 33 samples were obtained from LNs and seven samples from intrapulmonary lesions. Twenty out of the 23 lung cancer diagnoses were clarified through the procedure, with sensitivity, specificity, positive predictive value, negative predictive value and accuracy being 87%, 100%, 100%, 70% and 90%, respectively. All three false negative cases were found in the first five procedures. Additionally, among the 33 LNs examined, three specimens that had no lymphocytes were also found within the first five procedures. There were no major complications, and the procedures were uneventful.</p><p><b>CONCLUSIONS</b>EBUS-TBNA seems a safe and effective technique in making diagnosis for mediastinal/hilar LNs and intrapulmonary masses. For pulmonologists experienced in bronchoscopy, the sensitivity of the procedure for diagnosing lung cancer should be no less than 90% after the initial five procedures.</p>

Treatment of allergic rhinitis with nasal mometasone furoate / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the effects of nasal mometasone furoate on moderate to severe allergic rhinitis.</p><p><b>METHODS</b>Patients with moderate to severe allergic rhinitis were enrolled and received mometasone furoate nasal spray 200 microg once daily for four weeks. Four hundreds and sixty-three patients completed the study. We weekly interviewed the patients to evaluate the symptoms, and the affection of disease on night sleep and daily life. Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ) and Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ) were used to evaluate the quality of life.</p><p><b>RESULTS</b>The individual and total symptomatic scores of week 1, week 2 and week 4 decreased compared with baseline. The scores of Mini-RQLQ and NRQLQ of week 1, week 2 and week 4 decreased compared with baseline too. The scores of the next visit were significantly lower than those of the previous visit (P < 0.01).</p><p><b>CONCLUSIONS</b>A four-week administration of mometasone furoate nasal spray can effectively treat allergic rhinitis.</p>

Clinical and histopathological alterations of lymphangioleiomyomatosis in 14 Chinese patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Lymphangioleiomyomatosis (LAM) is a rare disease that predominantly affects young females. It is considered as an "orphan" life-threatening disease of unknown etiology, with uncertain clinical prognosis, and no effective treatment. LAM can arise sporadically or in association with tuberous sclerosis complex (TSC), an autosomal inherited syndrome characterized by hamartoma-like tumor growth and pathologic features that are distinct from manifestations of pulmonary LAM. The clinical course of LAM is characterized by progressive dyspnea on exertion, recurrent pneumothorax, and chylous fluid collections.</p><p><b>METHODS</b>Fourteen cases of LAM from Zhongshan Hospital, Fudan University are reviewed, twelve were confirmed by lung biopsy, one by retroperitoneal lymphangioleiomyoma resection, and one by autopsy.</p><p><b>RESULTS</b>All 14 patients were women, aged 18 to 69 years (mean 43.3 years, median 46.5 years). Haemoptysis (57.1%) and chylothorax (35.7%) were more frequent than those described in previous case series. Extrapulmonary findings such as renal angiomyolipoma (AML), enlarged abdominal lymph nodes, liver AML and retroperitoneal lymphangioleiomyoma were seen in 21.4%, 14.3%, 7.14% and 7.14% in 14 cases respectively, which is remarkably lower than in the previously reported. Abnormal smooth muscle cells (LAM cells) were found to line the airways, bronchioles, lymphatics and blood vessels leading to airflow obstruction and replacement of the lung parenchyma by cysts. There were some surprises in the autopsy case as several LAM cell emboli were found in the veins of mediastinum lymph nodes; LAM cells were found to be disseminated in soft tissues adjacent to the ilium.</p><p><b>CONCLUSIONS</b>Women with unexplained recurrent pneumothorax, tuberous sclerosis, or a diagnosis of primary spontaneous pneumothorax or emphysema in the setting of limited or absent tobacco use should undergo high-resolution computed tomography (HRCT) scan screening for LAM. Routine abdominal and pelvic imaging examinations should be performed to detect extrapulmonary involvement. The autopsy studies histologically suggested that LAM could be a multisystemic disease and LAM cells might possess metastatic potential.</p>