Emodin suppresses alkali burn-induced corneal inflammation and neovascularization by the vascular endothelial growth factor receptor 2 signaling pathway.

OBJECTIVE: To investigate the effects of emodin on alkali burn-induced corneal inflammation and neovascularization. METHODS: The ability of emodin to target vascular endothelial growth factor receptor 2 (VEGFR2) was predicted by molecular docking. The effects of emodin on the invasion, migration, and proliferation of human umbilical vein endothelial cells (HUVEC) were determined by cell counting kit-8, Transwell, and tube formation assays. Analysis of apoptosis was performed by flow cytometry. CD31 levels were examined by immunofluorescence. The abundance and phosphorylation state of VEGFR2, protein kinase B (Akt), signal transducer and activator of transcription 3 (STAT3), and P38 were examined by immunoblot analysis. Corneal alkali burn was performed on 40 mice. Animals were divided randomly into two groups, and the alkali-burned eyes were then treated with drops of either 10 µM emodin or phosphate buffered saline (PBS) four times a day. Slit-lamp microscopy was used to evaluate inflammation and corneal neovascularization (CNV) in all eyes on Days 0, 7, 10, and 14. The mice were killed humanely 14 d after the alkali burn, and their corneas were removed and preserved at －80 ℃ until histological study or protein extraction. RESULTS: Molecular docking confirmed that emodin was able to target VEGFR2. The findings revealed that emodin decreased the invasion, migration, angiogenesis, and proliferation of HUVEC in a dose-dependent manner. In mice, emodin suppressed corneal inflammatory cell infiltration and inhibited the development of corneal neovascularization induced by alkali burn. Compared to those of the PBS-treated group, lower VEGFR2 expression and CD31 levels were found in the emodin-treated group. Emodin dramatically decreased the expression of VEGFR2, p-VEGFR2, p-Akt, p-STAT3, and p-P38 in VEGF-treated HUVEC. CONCLUSION: This study provides a new avenue for evaluating the molecular mechanisms underlying corneal inflammation and neovascularization. Emodin might be a promising new therapeutic option for corneal alkali burns.

Study on the fastening characteristics of preformed helical fittings considering the surface effect of transmission lines.

Because of their superior mechanical properties, preformed helical fittings are widely used in UHV transmission lines. However, they easily slip and become loose under extreme environments, so it is very important to study the fastening characteristics of preformed helical fittings. According to the stress characteristics of preformed helical fittings, a parametric finite element model including a core and preformed armor rods was established. Finally, the finite element model calculation was verified by comparing it with the test results. In this paper, the influences of the preformed armor rod diameter, pitch, length and forming aperture on the fastening characteristics were investigated. The numerical simulation results showed that the smaller the forming aperture of preformed armor rods, the larger the grip force. However, a small forming aperture is inconvenient to install, and too large of a grip force on the core easily leads to core damage. With the increase in the preformed armor rod length, the grip force increased gradually and linearly, and the increase slowed after the pitch number reached 9. The larger the pitch, the smaller the grip force of the preformed helical fittings. The fastening characteristics of preformed armor rods with slightly larger diameters were better and the fourth power of the diameter of the preformed armor rods has a linear relationship with the grip force.

Analysis of clinical features and genetic variant in a neonate with Au-Kline syndrome due to a de novo variant of the HNRNPK gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical phenotype and genetic basis of a neonate with Au-Kline syndrome (AKS).@*METHODS@#Clinical data and result of genetic testing of a neonate with AKS who was admitted to the Affiliated Provincial Children's Hospital of Anhui Medical University in January 2021 were retrospectively analyzed. Relevant literature was searched from the Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure and PubMed databases using key words "Au Kline syndrome", "Au-Kline syndrome", "HNRNPK" and "AKS". The research period was set as from January 1, 2000 to December 31, 2020.@*RESULTS@#The male newborn has manifested feeding difficulties, hypotonia, absence of the upper jaw to the uvula and facial dysmorphism. Trio-whole exome sequencing revealed that he has harbored a frameshift c.478dupA (p.Ile160AsnfsTer7) variant of the HNRNPK gene, which was varified by Sanger sequencing to have a de novo origin. The variant has not been included in the databases. Based on the guidelines from the American College of Medical Genetics and Genomics, the variant was rated as pathogenic (PVS1+PS2+PM2_Supporting). Literature retrieval has identified 14 children with AKS and de novo mutations of the HNRNPK gene. Their clinical manifestations have included growth and motor retardation, various degree of mental retardation, facial dysmorphism and a high frequency of congenital heart malformations.@*CONCLUSION@#The AKS in this child may be attributed to the c478dupA frameshifting variant of the HNRNPK gene. Diagnosis of AKS should be suspected for children with mental retardation and multiple congenital malformation syndromes including Kabuki syndrome.

Factor analysis of effective platelet-producing ability of fetal liver-derived cells / 中华内科杂志

Objective:To study the different factors affecting platelet production post transplantation of hematopoietic stem cells (HSCs) isolated from different sources in order to explore novel options for treating platelet depletion following HSCs transplantation.Methods:HSCs and their downstream derivatives including myeloid and lymphoid cells (i.e., collective of mononuclear cells (MNCs)), were isolated from E14.5 fetal liver (FL) and bone marrow (BM) of 8-week-old mice by Ficoll separation technique. These cells were subsequently transplanted into the tibia bone marrow cavity of recipient mice post lethal myeloablative treatment in order to construct the FL-MNCs and BM-MNCs transplantation mouse model. Routine blood indices were examined in these recipient mice. The chimeric rate of donor cells in recipient peripheral blood cells were determined by flow cytometry. Different groups of cells involved in platelet reconstruction were analyzed. CD41 +megakaryocytes were sorted from fetal liver or bone marrow using magnetic beads, which were then induced to differentiate into platelets in an in vitro assay . Quantitative RT-PCR was used to detect the expression of platelet-related genes in CD41 +megakaryocytes from the two sources. Results:Both the FL-MNCs and the BM-MNCs transplantation groups resumed normal hematopoiesis at the 4th week after transplantation, and the blood cells of the recipient mice were largely replaced by the donor cells. Compared with the mice transplanted with BM-MNCs, the platelet level of mice transplanted with FL-MNCs recovered faster and were maintained at a higher level. At week 4, the PLT level of the FL-MNCs group was (1.45±0.37)×10 12/L, and of the BM-MNCs group was (1.22±0.24)×10 12/L, P<0.05. The FL-MNCs contain a higher proportion of hematopoietic stem cells (Lin -Sca-1 +c-Kit +)(7.60%±1.40%) compared to the BM-MNCs (1.10%±0.46%), P<0.01; the proportion of the megakaryocyte progenitor cells (Lin -Sca-1 -c-Kit +CD41 +CD150 +) and mature megakaryocyte cells (CD41 +CD42b +), also differ significantly between the FL-MNCs (3.05%±0.22%, 1.60%±0.06%, respectively) and the BM-MNCs (0.15%±0.02%, 0.87%±0.11%, respectively) groups, both P<0.01. In vitro functional studies showed that FL-MNCs-CD41 +megakaryocytes could produce proplatelet-like cells more quickly after induction, with proplatelet-like cells formation on day 3 and significant platelet-like particle formation on day 5, in contrast to bone marrow-derived BM-MNCs-CD41 +megakaryocytes that failed to form proplatelet-like cell on day 5. In addition, FL-MNCs-CD41 +cells expressed higher levels of platelet-related genes, Mpl (3.25-fold), Fog1 (3-fold), and Gata1 (1.5-fold) ( P<0.05). Conclusion:Compared with the BM-MNCs group, the FL-MNCs transplantation group appears to have a more efficient platelet implantation effect in the HSCs transplantation recipient in vivo , as well as a higher platelet differentiation rate in vitro. This might be related to a higher proportion of megakaryocytes and higher expression levels of genes such as Mpl, Fog1, and Gata1 that could be important for platelet formation in FL-MNCs-CD41 +cells. Further exploration of the specific functions of these genes and the characteristics of the different proportions of the donor cells will provide valuable clues for the future treatment of platelets reconstitution after HSCs transplantation clinically.

Guidelines for diagnosis and nutritional intervention of mild to moderate non-IgE mediated cow′s milk protein allergy in Chinese infants / 中华实用儿科临床杂志

Cow′s milk protein allergy (CMPA) is one of the most common presentations of food allergy seen in early childhood.It is an abnormal immune response caused by cow′s milk protein.CMPA can be clinically subdivided into either immediate-onset IgE mediated or delayed onset non-IgE mediated, or both.At present, concerns regarding the early and timely diagnosis of CMPA have been high-lighted over the years and there are many expert consensus on CMPA in China, but these consensus did not distinguish IgE mediated or non-IgE mediated CMPA.In view of the obvious clinical differences between the two type of CMPA and non-IgE mediated CMPA is more common in infancy, experts focus on pediatric gastroenterology, allergy/immunology, dermatology, nutrition and child healthcare convened by the Allergy Prevention and Control Professional Committee of Chinese Preventive Medicine Association present this guideline to help practitioners in primary care settings to early recognize and make suitable management of non-IgE mediated CMPA in China.The guideline incorporates the cutting-edge international guidance and the actual situation of Chinese children describing in detail the types, clinical features, diagnosis and nutritional intervention of non-IgE mediated CMPA.There are 42 recommendations in 7 categories in total referring to the common questions related to non-IgE mediated CMPA.

Clinical characteristics and genetic analysis of a neonate with Smith-Magenis syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical features and genetic etiology for a neonate with Smith-Magenis syndrome (SMS).@*METHODS@#Copy number variation sequencing (CNV-seq) was applied to the neonate and his parents, and the genotype-phenotype correlation was analyzed.@*RESULTS@#On the second day after birth, the neonate had presented with pathological jaundice and immunodeficiency. Cranial MRI revealed ventricular enlargement and enlargement of cisterna magna. At 3 months, the infant has presented with square face, prominent forehead, deep-set eyes, hypertelorism, palpebral fissure upward and button noses. Genetic testing showed that he had carried a 2.9 Mb deletion in 17p11.2 region, seq[GRCh37] del(17)(p11.2)(chr17:16 836 379-19 880 992). The same deletion was not found in either parent.@*CONCLUSION@#SMS is mostly diagnosed in child and adulthood, but rarely in neonates. For neonates with SMS, the neurological and behavioral abnormalities have not been shown, but pathological jaundice, CNS abnormalities and immune deficiency may be the characteristics, which require attention of neonatal physicians.

Prehospital scales predict large vessel occlusion in patients with acute ischemic stroke: a comparison of 10 scales / 国际脑血管病杂志

Objective@#To compare the predictive value of 10 prehospital assessment scales for large vessel occlusion in patients with acute ischemic stroke.@*Methods@#From January 2016 to December 2018, patients with acute ischemic stroke within 24 h of onset admitted to the Department of Neurology, Nanfang Hospital, Southern Medical University were enrolled retrospectively. The scores of various scales were calculated based on clinical data, including the National Institutes of Health Stroke Scale (NIHSS), Los Angeles Motor Scale (LAMS), and 3-item stroke scale (3I- SS), Prehospital Acute Stroke Severity Scale (PASS), Ambulance Clinical Triage For Acute Stroke Treatment (ACT-FAST), and Stroke Vision, Aphasia, and Neglect Assessment Scales (VAN), etc. The predictive threshold of the NIHSS score was determined, and the receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the effectiveness of various prehospital scales to predict large vessel occlusion.@*Results@#A total of 705 patients with acute ischemic stroke within 24 h of onset were enrolled, including 252 (35.7%) with large vessel occlusion. The best predictive cutoff value for judging large vessel occlusion by the NIHSS score was 9, sensitivity was 81.7%, specificity was 79.7%, positive likelihood ratio was 4.851, and negative likelihood ratio was 0.260. LAMS score ≥4 (sensitivity 88.1%, specificity 81.0%, positive likelihood ratio 4.640, and negative likelihood ratio 0.247), VAN positive (sensitivity 83.7%, specificity 82.3%, positive likelihood ratio 4.741, and negative likelihood ratio 0.198) and NIHSS score ≥9 were more accurate in identifying large vessel occlusion. The AUC values of the 8 quantitative scores were all > 0.7, and the AUC of LAMS was the largest (0.852, 95% confidence interval 0.825-0.878).@*Conclusions@#In patients with acute ischemic stroke within 24 h of onset, the NIHSS score ≥9 can be used as the best cutoff value for predicting large vessel occlusion events. LAMS, VAN, and NIHSS scales are more accurate in predicting large vessel occlusion. The predictive power of the 8 quantitative scales is higher, and the AUC of LAMS is the largest, which can be used for clinical prediction of large vessel occlusion in patients with acute ischemic stroke.

Outcomes of patients treated with drug-coated balloons for de novo large coronary vessels / 中华心血管病杂志

Objective@#To evaluate the efficacy and safety of drug-coated balloons (DCB) for de novo large coronary vessels.@*Methods@#One hundred and two patients were retrospectively enrolled in this study, there were 104 lesions with the reference lumen diameter of target vessel more than 2.8 mm and patients were treated with DCB in de novo lesions during May 2015 and July 2017 in our center. Coronary artery angiography and quantitative coronary angiography were performed in 82 (80.4%) patients at follow up period ((8.1±1.7) months post procedure). The endpoints were late lumen loss (LLL) at follow up,and major adverse cardiac events (MACE) including cardiac death, myocardial infarction (MI), target lesion revascularization (TLR) and stent or target lesion thrombosis at 12 months post procedure.@*Results@#Ninety-eight lesions were treated with DCB only, 6 (5.9%) bailout drug-eluting stent (DES) were used because of severe coronary dissection, 2 patients (2.0%) received revascularization driven by acute ischemic events during hospitalization. Cutting balloons and NSE balloons were used in 65.4% (68/104) and 26.0% (27/104) lesions. The lesion length was (12.57±3.58) mm and the DCB length was (19.87±4.55) mm. The late lumen loss was (0.01±0.52) mm during angiographic follow up. The TLR rate and overall MACE rate was 3.9% (4/102) and 3.9% (4/102) and there was no death,MI and target lesion thrombosis at 12 months follow up.@*Conclusion@#DCB treatment for de novo large coronary vessels is effective and safe.

Purification and cultivation of mouse primary retinal microvascular pericytes based on pre-incubation / 中华实验眼科杂志

Objective@#To establish a simple method for isolation, purification and cultivation of primary retinal microvascular pericytes (RMPs) from mice.@*Methods@#Retinas were isolated from mice following with mechanical morcel, enzymatic digestion and filtration.The retinal fragments were incubated with low glucose DMEM with 20% fetal bovine serum after 24 hours pre-incubation.Differential digestion was used for purification of primary RMPs.Morphological examination of cells was performed by phase contrast microscopy, and further characterization was analyzed by immunocytochemistry.Functional assay was evaluated by the pericytes-endothelial cells (ECs) co-culture system.The treatment and use of experimental animals followed the regulations on the administration of experimental animals promulgated by the state science and technology commission.@*Results@#Cells migrated out of fragments after 24 hours of incubation, and developed into small or large colonies gradually.The cells and their subpassages presented typical pericyte morphology with large irregular triangular cell bodies and multiple long processes.No contact inhibition was observed.Most cells uniformly expressed the cellular markers α-smooth muscle actin (α-SMA) and platelet-derived growth factor receptor-β (PDGFR-β), a few cells expressed the cellular markers glial fibrillary acidic protein (GFAP), but no cell expressed von Willebrand factor (vWF). The purity rate of RMPs was up to 97%.In the co-culture system, RMPs directly contacted with ECs to form the capillary-like cords in vitro.@*Conclusions@#A simple method for the isolation, purification cultivation of mouse RMPs is established, and active RMPs can be readily obtained by this method.

Purification and cultivation of mouse primary retinal microvascular pericytes based on pre-incubation / 中华实验眼科杂志

Objective To establish a simple method for isolation, purification and cultivation of primary retinal microvascular pericytes ( RMPs) from mice. Methods Retinas were isolated from mice following with mechanical morcel,enzymatic digestion and filtration. The retinal fragments were incubated with low glucose DMEM with 20％ fetal bovine serum after 24 hours pre-incubation. Differential digestion was used for purification of primary RMPs. Morphological examination of cells was performed by phase contrast microscopy, and further characterization was analyzed by immunocytochemistry. Functional assay was evaluated by the pericytes-endothelial cells ( ECs) co-culture system. The treatment and use of experimental animals followed the regulations on the administration of experimental animals promulgated by the state science and technology commission. Results Cells migrated out of fragments after 24 hours of incubation, and developed into small or large colonies gradually. The cells and their subpassages presented typical pericyte morphology with large irregular triangular cell bodies and multiple long processes. No contact inhibition was observed. Most cells uniformly expressed the cellular markers α-smooth muscle actin (α-SMA) and platelet-derived growth factor receptor-β( PDGFR-β) ,a few cells expressed the cellular markers glial fibrillary acidic protein ( GFAP) ,but no cell expressed von Willebrand factor ( vWF) . The purity rate of RMPs was up to 97％. In the co-culture system,RMPs directly contacted with ECs to form the capillary-like cords in vitro. Conclusions A simple method for the isolation, purification cultivation of mouse RMPs is established, and active RMPs can be readily obtained by this method.

Predictive value of posttreatment whole body scan for radiation damage to the salivary glands in patients with differentiated thyroid carcinoma / 中华核医学与分子影像杂志

Objective To evaluate the predictive value of posttreatment whole body scan (RxWBS) for radiation damage to the salivary glands in patients with differentiated thyroid carcinoma (DTC).Methods From April 2015 to June 2015,24 patients (8 males,16 females;age:26-64 years) with DTC,who accepted 131I therapy only one time and underwent Rx-WBS 2-4 d after 131I treatment,were recruited from the First Hospital of China Medical University.All patients had normal salivary glands function on salivary gland scintigraphy (SGS) performed on the day before 131I treatment,and 21 patients underwent SGS again 3 months after 131I treatment.The SGS results and clinical manifestations were used to evaluate the function of salivary glands after 131I therapy.Rx-WBS was analyzed by visual analysis and quantitative analysis (salivary gland to background uptake ratios,SUR).The SUR was compared between patient groups with different function of salivary glands.Mann-Whitney u test was used.Receiver operating characteristic (ROC) curve analysis was used to calculate the sensitivity of SUR for predicting the salivary gland damage.Results The SUR in dysfunctional parotid glands (n =12) was significantly higher than that in other glands with normal function (n=30;3.60(2.55,4.33) vs 2.75(2.33,3.29);z=-2.005,P＜0.05).The SUR was not different between submandibular glands with lower function (n =15) and those with normal function (n=27;z=-0.144,P＞0.05).The SUR of parotid glands (n =32) in patients with parotitis was significantly higher than that in others (n=16;3.16(2.53,4.01) vs 2.49(206,2 81);z=-3.073,P＜0.05).The SUR of submandibular glands (n=28) in patients with sialadenitis was significantly higher than that in others (n=20;4.43(2.67,7.61) vs 2.93(1.92,4.65);z=-2.740,P＜0.05).When 2.97 and 3.66 were selected as cutoff values,the sensitivities of SUR for predicting parotitis and sialadenitis were 59％(19/32) and 64％ (18/ 28),respectively.Conclusion Rx-WBS may play a role in predicting radiation damage to the salivary glands.

Effects of neonatal hypoglycemia on temperament and neurobehavioral development of preschool children / 医学研究生学报

Objective Neonatal hypoglycemia is a common metabolic disease during neonatal period and a few children with neonatal hypoglycemiamay show a series of neurologic impairment.This study was to explore the neurobehavioral development of preschool children with neonatal hypoglycemia.Methods 37 children with neonatal hypoglycemia in Neonate Department of Anhui Provincal Children's Hospital from March 2009 to May 2013 were investigated by Chinese Preschool-Children Temperament Scale and Conners Symptoms Questionnaire for Parents, together with the information collection of perinatal period, clinical data and family environment.At the same time 50 controls were randomly chosed of the same period.Results The children of hypoglycemia group and control group were mainly with easy temperament and inclined easy temperament.In the nine dimensions of temperament, there was statistical difference in approach-withdraw between two groups (P<0.05).The incidence of behavioral problem in hypoglycemia group is 24%, involving learning problem and psychophysical problem, and there were statistical difference between two groups in this aspect (P<0.05).Conclusion Neonatal hypoglycemia affects the neurobehavioral development of preschool children.Individualized treatment and education intervention should be taken according to the children's temperament and neurobehavioral development.

One-stage treatment with autologous red bone marrow transplantation for femoral comminuted fracture / 中国组织工程研究

BACKGROUND: Whether one-stage bone healing with red bone marrow or mesenchymal stem cell transplantation is needed? Whether closed reduction with intramedullary interlocking nailing combined with autologous red bone marrow transplantation can promote osteogenesis in the one-stage treatment of femoral comminuted fracture still remains unclear. OBJECTIVE: To explore the effects of closed reduction with intramedullary interlocking nailing and one-stage treatment with autologous red bone marrow transplantation on fracture healing. METHODS: Twenty healthy New Zealand rabbits were selected and anesthetized, and then the models of femoral comminuted fracture were established at the hinder limbs after throwing a 5 kg of hammer from 30 cm height. All rabbits underwent intramedullary fixation using Kirschner wire (diameter: 2 mm); the right limbs served as control groups, and the left limbs as transplantation group, subjected to the injection of autologous red bone marrow (1 mL) into the fracture region. Then the rabbits were respectively killed at 14, and 28 days after modeling, the thickness of thickest callus was measured on X-ray films, and the number of chondrocytes and relative area of bone trabecula in the fracture region were observed through hematoxylin-eosin staining under light microscope.RESULTS AND CONCLUSION: (1) The thickness of callus formation in the control group was significantly less than that in the transplantation group at 14 days after modeling (P < 0.01). (2) The number of chondrocytes in the transplantation group was significantly more than that in the control group at 14 days after modeling (P < 0.01),and the fracture healing in the transplantation group was faster that in the control group. (3) Compared with the transplantation group, the relative area bone trabecula in the fracture region in the control group was significantly reduced at 28 days after modeling (P < 0.01). (4) These finding indicate that red bone marrow transplantation promotes fracture healing in the intramedullary fixation for femoral comminuted fracture in rabbits.

Construction of ARIMA time series model for healthcare-associated infection in hospitalized children / 中国感染控制杂志

Objective To investigate the applicability of autoregressive integrated moving average (ARIMA) model in predicting healthcare-associated infection(HAI) in children.Methods The ARIMA model was constructed according to the incidence of HAI in a hospital from January 2011 to December 2014.With the use of information criterion,optimal model was determined;HAI data in 2015 was as test samples,the feasibility of the model was evaluated.Results ARIMA (0,1,1) was the optimal prediction model for HAI rate,the Akaike Information Criterion (AIC) and Bayesian Information Criterion(BIC) of the ARIMA (0,1,1) were 66.61 and 70.76,respectively.The Ljung-Box statistics value Q =14.14 was not significantly different (P =0.658),suggesting a white noise sequence of residuals with a good model fitting.The mean absolute percent error(MAPE) between actual and fitting value of HAI was 22.4,the actual values were within the 95％ confidence interval.Conclusion ARIMA model fits the time series data,and can achieve satisfactory effect on predicting the incidence of HAI in hospitalized children.

Correlation between platelet to lymphocyte ratio and microangiopathyin type 2diabetes mellitus / 实用医学杂志

Objective To explore the relationship between platelet to lymphocyte ratio (PLR) and microangiopathyin type 2 diabetes mellitus. Methods In this case-control study, the clinical data on 428 adult patients with type 2 diabetic microangiopathy in our hospital from January 2009 to December 2015 were retrospectively analyzed. PLR, age, sex, fasting blood glucose, glycosylated hemoglobin, total cholesterol and triglyceride were tested to investigate their relationship with type 2 diabetic microangiopathy. Results Logistic regression analysis showed that PLR was a risk factor of type 2 diabetic microangiopathy (OR = 3.162, 95%CI:1.556 ~ 7.421, P < 0.05). Conclusions Greater PLR is closely related to type 2 diabetic microangiopathy, and we should pay attention to type 2 diabetic microangiopathy with a greater PLR in clinical practice.

Systemic Reactions to Dust Mite Subcutaneous Immunotherapy: A 3-Year Follow-up Study

PURPOSE: The incidence of allergen specific immunotherapy-related systemic reactions (SRs) varies among different studies, and many factors are likely to contribute to SRs. This study aims to investigate the incidence, characteristics, and risk factors of SRs to standardize dust mite-specific subcutaneous immunotherapy (SCIT) in Central China. METHODS: All patients receiving standardized dust mites (100-100,000 SQ-U/mL; Alutard SQ, Hørsholn, Denmark) immunotherapy were followed up. Recorded data included demographics, diagnosis, patient status, pulmonary function testing results before and after each injection, allergen dosage, and details of SRs. RESULTS: From June 2011 to August 2014, a total of 208 patients received 4,369 injections; 27 (13.0%) patients experienced 48 (1.1%) systemic reactions. Most of the SRs were grade 2 reactions (n=30, 62.5%), followed by grade 1 (n=11, 22.9%), grade 3 (n=7, 14.6%), and no fatal reactions occurred. Forty-six SRs (95.8%) occurred within 30 minutes. Higher SR rates were associated with high concentration extracts (100,000 SQ-U/mL), injections with concomitant local reactions (LRs), children, asthma and high sensitivity (skin prick test 3+/4+ and/or sIgE≥17.5 kUA/L) (P<0.05). The estimated odds of SRs increased in children (OR=6.57; 95% CI: 1.88-22.97, P=0.003), asthmatic patients (OR=4.10; 95% CI: 1.72-9.80, P=0.002), and injections with LRs (OR=2.41; 95% CI: 1.33-4.36, P=0.004). CONCLUSIONS: The incidence of SRs to dust mite SCIT was low, and multiple factors were associated with the increased incidence of SRs. Children, asthmatics and patients with concomitant LR may be prone to develop SRs.

Knowledge, attitudes, and practices survey of drug allergy among healthcare practitioners in central China: a multicenter study

BACKGROUND: Drug allergy (DA) is one of the most important contributors to iatrogenic morbidity and mortality. Currently DA remains a major challenge for healthcare practitioners (HCPs). OBJECTIVE: To assess the knowledge, attitudes and practices of DA among HCPs in Central China. METHODS: A 25-item self-administered DA questionnaire were developed and applied in our study. The questionnaire covered 3 domains: knowledge, attitudes, and practice patterns. From July 2015 to October 2015, HCPs in 7 cities of Central China anonymously participated in the cross-sectional study. RESULTS: A total of 350 HCPs participated the study, 91 questionnaires uncompleted and 259 were analyzed. Among the respondents, 166 (64.1%) were doctors, 55 (21.2%) were nurses and 38 (14.7%) were medical students. The mean knowledge precision was 59.8%. HCPs agreed that drug induced immediate allergic reactions were IgE mediated (83.4%) and happened within 6 hours after drug administration (89.6%), and epinephrine was the first choice for drug induced anaphylaxis (79.5%). They also agreed that penicillin skin test was valuable to predict allergic reaction (88.4%). However, high proportion of HCPs (66.0%) believed glucocorticoids had an impact on drug skin test rather than antihistamines (4.2%), 47.1% never performed positive and negative control during skin test. More than 90% of the respondents would take patients' allergic history before drug administration, 98.8% agreed that they should receive advanced training of DA knowledge and practice. CONCLUSION: The HCPs demonstrated a low level of knowledge regarding DA. Advanced education is urgently needed for better understanding and filling the gaps exist in knowledge and clinical practice of DA.

Effects of different elevated CO2 concentrations on chlorophyll contents, gas exchange, water use efficiency, and PSII activity on C3 and C4 cereal crops in a closed artificial ecosystem.

Although terrestrial CO2 concentrations [CO2] are not expected to reach 1000 µmol mol(-1) (or ppm) for many decades, CO2 levels in closed systems such as growth chambers and greenhouses can easily exceed this concentration. CO2 levels in life support systems (LSS) in space can exceed 10,000 ppm (1 %). In order to understand how photosynthesis in C4 plants may respond to elevated CO2, it is necessary to determine if leaves of closed artificial ecosystem grown plants have a fully developed C4 photosynthetic apparatus, and whether or not photosynthesis in these leaves is more responsive to elevated [CO2] than leaves of C3 plants. To address this issue, we evaluated the response of gas exchange, water use efficiency, and photosynthetic efficiency of PSII by soybean (Glycine max (L.) Merr., 'Heihe35') of a typical C3 plant and maize (Zea mays L., 'Susheng') of C4 plant under four CO2 concentrations (500, 1000, 3000, and 5000 ppm), which were grown under controlled environmental conditions of Lunar Palace 1. The results showed that photosynthetic pigment by the C3 plants of soybean was more sensitive to elevated [CO2] below 3000 ppm than the C4 plants of maize. Elevated [CO2] to 1000 ppm induced a higher initial photosynthetic rate, while super-elevated [CO2] appeared to negate such initial growth promotion for C3 plants. The C4 plant had the highest ETR, φPSII, and qP under 500-3000 ppm [CO2], but then decreased substantially at 5000 ppm [CO2] for both species. Therefore, photosynthetic down-regulation and a decrease in photosynthetic electron transport occurred by both species in response to super-elevated [CO2] at 3000 and 5000 ppm. Accordingly, plants can be selected for and adapt to the efficient use of elevated CO2 concentration in LSS.

Changes of plasma cortisol and adrenocorticotropic hormone of preterm infants with respiratory failure / 中华实用儿科临床杂志

Objective To observe the concentration changes of plasma cortisol ( Cor ) and adrenocorticotropic hormone( ACTH) in preterm infants with respiratory failure receiving ventilation treatment. Methods The 30 preterm in-fants with respiratory failure requiring mechanical ventilation were selected as the preterm group with respiratory failure, and 32 full term infants with respiratory failure in need of mechanical ventilation were selected as the term infant group with respiratory failure, and 52 preterm infants( preterm control group) and 17 full term infants( term control group) were selected as controls. All the cases were chosen from Neonatal Intensive Care Unit of Anhui Province Children′s Hospital during January to December 2014. The levels of plasma Cor and ACTH were measured and analyzed. Results (1) Cor level:on the 3rd day, the level of plasma Cor in the preterm group with respiratory failure was lower than that in the term group with respiratory failure[262. 50(162. 00-332. 50) nmol/L vs 531. 00(244. 75-644. 00) nmol/L], and higher than those in the preterm control group[199. 50(49. 05-388. 95) nmol/L] and term control group[120. 00(43. 90-191. 00) nmol/L], the differences were statistically significant(all P<0. 05). On the 7th day, the level of plasma Cor in the preterm group with respiratory failure was lower than that in the term group with respiratory failure[128. 00(65. 85-244. 00) nmol/L vs 222. 00 (131. 50-377. 85) nmol/L], the difference was statistically significant(P<0. 05). (2) ACTH level:on the 3rd day, the level of ACTH in the preterm group with respiratory failure was higher than those in the other groups[38. 20(25. 18-76. 65) pmol/L vs 24. 60(19. 03-38. 20) pmol/L vs 22. 30(14. 40-40. 60) pmol/L vs 24. 20(13. 90-45. 65) pmol/L], the differences were statistically significant(P<0. 05). On the 7th day, the concentration of ACTH in the preterm group with respiratory failure was lower than those in the term group with respiratory failure[16. 55(12. 78-31. 80) pmol/L vs 29. 85(18. 23-54. 65) pmol/L], and there were statistical differences(P<0. 05). Conclusions The newborns with respiratory failure were in criti-cal stress, the level of plasma Cor in the preterm infants with respiratory failure was lower than that of the term infants with respiratory failure, while the level of ACTH in the former was higher than that in the latter. And when the stress disap-peared, both of the plasma Cor and ACTH recovered to the normal level.

Wheat - Dependent Exercise-Induced Anaphylaxis Occurred With a Delayed Onset of 10 to 24 hours After Wheat Ingestion: A Case Report.

Wheat-dependent exercise-induced anaphylaxis (WDEIA) usually occurs 1 to 4 hours after wheat ingestion and the pathophysiology of WDEIA remains unknown. It is recommended that WDEIA patients refrain from exercise for 4 to 6 hours after wheat ingestion. We report a case of a 51-year-old man who experienced 5 anaphylaxis attacks; two of which occurred 10 to 24 hours after wheat ingestion and exercise. He has a history of chronic gastroenteritis that responds well to antihistamine drugs but not proton pump inhibitors (PPIs) and prokinetic agents. Abdominal CT results implied the possibility of superior mesenteric artery syndrome. We suggest that WDEIA occurs 6 hours after wheat ingestion in cases compounded by obstructive gastrointestinal diseases.