郑州地区成人自报过敏性鼻炎患者吸入过敏原分析

  目的  了解郑州地区成人自报过敏性鼻炎(allergic rhinitis, AR)患者吸入过敏原致敏谱,分析不同年龄、性别及年份间阳性致敏原的差异,为AR的临床诊治提供参考。  方法  采用17种吸入过敏原试剂对2019年1月—2021年12月就诊于河南省人民医院过敏反应科门诊且自报为AR的成人患者2 305例进行皮肤点刺试验(skin prick test, SPT),比较不同性别、年龄、年份致敏原分布情况,并对阳性率进行分析。  结果  2 305例AR患者SPT阳性率为77.09%,常合并多种过敏原致敏,对4种及以上过敏原阳性者1 137例(49.33%);过敏原阳性率前5位依次为粉尘螨(42.78%)、户尘螨(38.61%)、梧桐花粉(35.27%)、蒿属花粉(34.27%)、葎草花粉(31.63%);18~30岁年龄组过敏原SPT阳性检出率达峰值(91.84%),阳性率随年龄增长而下降;不同性别间粉尘螨、户尘螨、油菜花、葎草花粉SPT阳性率比较差异有统计学意义(均P＜0.05);2019—2021年室内吸入过敏原粉尘螨、户尘螨阳性率呈逐年升高趋势,季节性吸入过敏原梧桐花粉、蒿属花粉、葎草花粉阳性率呈逐年下降趋势。  结论  AR患者常合并4种及以上吸入过敏原致敏;18~30岁SPT检出率达峰值;粉尘螨、户尘螨、梧桐花粉、蒿属花粉、葎草花粉是郑州地区成人自报AR患者最常见的致敏原。      

徐州地区变应性鼻炎患者变应原分布特点及结果分析

目的:了解徐州地区变应性鼻炎(allergic rhinitis,AR)患者的变应原分布状况,为当地AR的防治提供参考。方法:对1 863例疑似变应性鼻炎患者进行皮肤点刺试验(skin prick test SPT),测定致敏变应原,并进行统计学分析。结果:1 863例患者中SPT阳性率为72.95%,其中屋尘螨(87.49%)、粉尘螨(70.79%)、树木花粉(62.10%)为主要变应原;随患者年龄增加,变应原阳性率呈下降低趋势;各月份变应原阳性率不同,其中5月份阳性率最高,为29.47%。结论:屋尘螨、粉尘螨、树木花粉为徐州地区AR患者主要吸入性变应原。     

北京地区可疑过敏性鼻炎病人吸入性变应原特征分析

目的回顾性分析可疑过敏性鼻炎(allergic rhinitis,AR)病人进行皮肤点刺试验(skin prick test,SPT)后吸入性变应原特征,为AR的临床诊疗提供帮助。方法对2011年1月1日至2013年7月31日就诊于首都医科大学附属北京同仁医院的北京地区2 598例具有AR典型症状的病人进行皮肤点刺试验,分析比较不同病人变应原检测结果差异。结果 (1)在2 598例可疑过敏性鼻炎受试者中,有2 292例(88.2%)病人至少对一种变应原有临床意义上的阳性。(2)在AR病人中,SPT检测阳性率前4位的变应原依次为:粉尘螨(43.1%)、屋尘螨(37.6%)、德国小蠊(32.6%)、艾蒿(26.6%)。就诊病人中女性居多,但SPT检测阳性率在性别间差异无统计学意义。(3)SPT检测阳性受试者中,单一变应原阳性(18.0%)、双重变应原阳性(22.6%)、三重变应原阳性(19.4%)占多数,未成年病人单一变应原阳性率较低。(4)AR就诊人数在4~6月和8~9月迎来两个高峰。(5)在单一变应原阳性病人中,德国小蠊阳性检出率(31.6%)远大于其他变应原。(6)粉尘螨、屋尘螨在不同年龄段变应原阳性检出率差异有统计学意义。结论粉尘螨、屋尘螨、德国小蠊、艾蒿是北京地区AR病人的主要变应原,变应原存在年龄及时间差异。     

广西梧州地区变应性鼻炎患者的变应原分布特点

目的:通过对梧州地区变应性鼻炎患者进行变应原检测及分析,筛查出本地区常见变应原,为防治变应性鼻炎提供统计学依据。方法:对在2010年11月至2013年5月期间到本院诊治的2800例疑似变应性鼻炎患者进行皮肤点刺试验,查找变应原,同时进行统计学分析。结果:在所检测的患者中有2221例(79.32%)变应原测试有阳性反应,在阳性患者中,吸入性变应原阳性率前三位依次为粉尘螨2040例(91.85%)、户尘螨1960例(88.25%)、蟑螂1056例(47.55%),食入组变应原以海蟹828例(37.28%)、海虾513例(23.10%)、扇贝234例(10.54%)为主。结论:在梧州地区导致变应性鼻炎的吸入性变应原中户尘螨、粉尘螨占据主要地位,应作为梧州地区的重点变应原开展变应性鼻炎的防治工作。     

过敏性鼻炎患者尘螨SPT反应强度与血清特异性IgE测定结果比较及相关性

目的 探讨过敏性鼻炎（AR）患者尘螨皮肤点刺试验（SPT）结果与血清特异性IgE测定结果比较及相关性。方法 选取2021年1-12月于东南大学医学院附属南京同仁医院就诊的143例过敏性鼻炎患者作为研究对象,检测患者尘螨SPT及血清特异性IgE,并分析其SPT反应强度与血清特异性IgE测定结果的联系。结果 143例患者户尘螨SPT和血清IgE阳性率比较、粉尘螨SPT和血清IgE阳性率比较差异均无统计学意义（χ2=0.116、2.217,P均>0.05）。143例AR患者户尘螨、粉尘螨SPT结果为阴性时,血清特异性IgE阴性率随着SI增大而降低;SPT结果为阳性时,IgE阳性率随着SI增大而增高,当SI>2.00时IgE阳性率为100%。143例患者户尘螨SPT、粉尘螨SPT反应强度与其血清特异性IgE水平均成正相关（r=0.551、0.560,P均<0.05）。结论 尘螨SPT和血清特异性IgE测定在AR患者的检测中有一定程度的正相关,在患者尘螨SPT结果为SI>2.00时可诊断AR,但在SI≤2.00时仍需行血清特异性IgE进一步确诊。     

南通地区变应性鼻炎749例过敏原检测分析

目的：检测南通地区变应性鼻炎（allergic rhinitis,AR）患者的过敏原,为预防和治疗该地区变应性鼻炎提供依据。方法：对临床诊断变应性鼻炎749例成人患者行变应原皮肤点刺试验,分析主要过敏原并排序。结果：749例患者皮肤点刺试验阳性358例（47.8%）,男性352例SPT阳性171例（48.6%）,女性397例SPT阳性187（47.1%）,男女患者皮肤点刺试验阳性率比较差异无统计学意义（P〉0.05）;其中屋尘螨228例（63.7%）、粉尘螨207例（57.8%）例、蟑螂164例（45.8%）为主要过敏原。结论：屋尘螨、粉尘螨及蟑螂是南通地区变应性鼻炎患者主要过敏原,该地区变应性鼻炎的过敏原筛查可选择以尘螨和蟑螂为重点。     

上海地区变应性鼻炎患者变应原特征分析

目的 回顾性分析疑似变应性鼻炎(allergic rhinitis,AR)患者过敏原的特征与发病季节分布。方法 选取2015年1月1日至2017年12月31日就诊于我院耳鼻咽喉头颈外科有典型AR症状并行变应原测试的患者1570例,分析变应原检测结果及季节分布。结果 有1182例(75.3%)检测出至少一种变应原阳性;单纯血清总IgE阳性者为143例(9.1%);检测出单一过敏原的AR患者为491例(31.3%),两种及以上过敏原AR患者为691(44.0%),其中尘螨(包括屋尘螨和粉尘螨)为最常见的过敏原,共有715例约占所有变应原阳性AR患者的60.5%,其次为青霉素为239例(20.2%);在每年的4~6月、8~11月为AR患者就诊高发期。17-39岁人群占比最高。结论 尘螨为上海地区部分AR患者的主要过敏原,AR发作有时间分布差异。     

重庆地区变态反应性疾病患者的变应原特征分析

目的：分析重庆地区变态反应性疾病患者吸入性变应原谱特点,进一步优选皮肤点刺试验（skin prick test,SPT）吸入性变应原的数目和种类。方法：对2014年9月至2016年8月于重庆市人民医院变态反应科就诊的2305例可疑变态反应性疾病患者行SPT,分析其结果。根据年龄、季节分层,描述吸入性变应原的分布特征,进一步优选SPT的变应原组合,使其可以检测≥95%的变应原阳性患者。结果：①2305例患者阳性数1672例,总阳性率为72.54%。SPT检测阳性率前6位的变应原依次为：粉尘螨（62.00%）、屋尘螨（58.61%）、蟑螂（28.81%）、猫毛（14.62%）、葎草（14.45%）、艾蒿（14.27%）。吸入性变应原阳性级别（+++）及以上的患者中,粉尘螨和户尘螨分别占两者的77.75%和76.24%,明显高于其他变应原。②不同季节变应原总阳性率（春季67.81%,夏季72.63%,秋季78.78%,冬季72.09%）差异有统计学意义（χ2=17.741,P=0.000）。尘螨阳性率与吸入性变应原总阳性率季节变化趋势相似。③不同年龄段变应原总阳性率（~17岁组为82.31%,18~39岁组为73.78%,40~59岁组为64.77%,60~岁组为54.97%）差异有统计学意义（χ2=65.456,P=0.000）。随着年龄增加吸入性变应原阳性率降低。④4个吸入性变应原（粉尘螨、蟑螂、屋尘螨、葎草）的SPT可以检测重庆地区可疑变态反应性疾病患者中≥95%的变应原阳性患者。结论：重庆地区变态反应性疾病最主要的吸入性变应原为粉尘螨和屋尘螨。吸入性变应原阳性率受季节、年龄的影响并存在一定的规律。4个吸入性变应原可以检测绝大多数吸入性变应原阳性患者,可以作为重庆地区变态反应性疾病吸入性变应原流行病学调查经济有效的变应原组。     

生物共振诊断治疗仪检测变应性鼻炎变应原的初步评估

目的 探讨摩拉生物共振诊断治疗仪(MORA-super)检测变应性鼻炎(allergic rhinitis,AR)变应原的准确性及临床意义.方法 选取2010年5 - 12月就诊于我院变态反应科的139例AR阳性病史的患者为研究对象,以常见的10种变应原测试液为抗原,依次进行生物共振诊断治疗仪检测及皮肤点刺试验检测(skin prick test,SPT),以AR阳性病史及SPT阳性结果与病史相符为AR诊断标准,并以确诊为AR患者的SPT检测结果为标准,评价生物共振诊断治疗仪检测结果.结果 139例患者中SPT阳性且与病史相符124例,确诊为AR,以确诊为AR的124例SPT检测结果为对照,生物共振诊断治疗仪检测屋尘螨符合率为83.8%,灵敏度78.6%,特异度88.2%,阳性预测值84.6%,阴性预测值83.3%；艾蒿符合率为85.5%,灵敏度80.0%,特异度89.2%,阳性预测值83.3%,阴性预测值86.8%.结论 生物共振诊断治疗仪检测变应性鼻炎变应原的检测结果与SPT结果符合率较高,其用于变应原检测确实可行.     

辽宁地区2883例变应性鼻炎患者变应原分布特征

目的了解辽宁地区变应性鼻炎(AR)主要变应原分布情况,为临床诊断、治疗和预防提供参考。方法选取2014年1月至2015年12月在解放军第四六三医院耳鼻喉科拟诊断为AR的2 883例患者作为研究对象,进行20种变应原特异性血清Ig E(sIgE)检查,统计并分析变应原分布情况特征。结果 2 883例AR患者血清中,2 565例(89.0%)至少一种变应原呈阳性。吸入性变应原阳性率为78.4%(2 260/2 883),食入性变应原阳性率为28.7%(827/2 883)。只有一种变应原阳性者638例,占阳性患者的24.9%;同时有两种或两种以上变应原阳性者1 927例,占75.1%。吸入性变应原阳性率前3位依次为尘螨组合1(屋尘螨/粉尘螨)、狗上皮、蟑螂,阳性率依次为68.9%、37.3%、25.4%;食入性变应原阳性率前3位为花生、鸡蛋白、牛奶,阳性率依次为18.3%、15.6%、14.3%。结论尘螨、狗上皮、蟑螂是辽宁地区AR患者的主要吸入性变应原,花生、鸡蛋白、牛奶是主要的食入性变应原。变应原特异性血清Ig E(sIgE)检查在AR的诊断和防治中具有重要意义。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.