Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry

Background

Peanut allergy has a rising prevalence in high-income countries, affecting 0.5%–1.4% of children. This study aimed to better understand peanut anaphylaxis in comparison to anaphylaxis to other food triggers in European children and adolescents.

Methods

Data was sourced from the European Anaphylaxis Registry via an online questionnaire, after in-depth review of food-induced anaphylaxis cases in a tertiary paediatric allergy centre.

Results

3514 cases of food anaphylaxis were reported between July 2007 - March 2018, 56% in patients younger than 18 years. Peanut anaphylaxis was recorded in 459 children and adolescents (85% of all peanut anaphylaxis cases). Previous reactions (42% vs. 38%; p = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .001) were more commonly reported in peanut anaphylaxis. Most cases were labelled as severe anaphylaxis (Ring&Messmer grade III 65% vs. 56% and grade IV 1.1% vs. 0.9%; p = .001). Self-administration of intramuscular adrenaline was low (17% vs. 15%), professional adrenaline administration was higher in non-peanut food anaphylaxis (34% vs. 26%; p = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .004).

Conclusions

The European Anaphylaxis Registry data confirmed peanut as one of the major causes of severe, potentially life-threatening allergic reactions in European children, with some characteristic features e.g., presence of asthma comorbidity and increased rate of biphasic reactions. Usage of intramuscular adrenaline as first-line treatment is low and needs to be improved. The Registry, designed as the largest database on anaphylaxis, allows continuous assessment of this condition.

     

平板运动试验不同阶段出现的室性心律失常分析

目的：通过进行平板运动试验鉴别室性早搏的性质。方法：从所有做平板运动试验的2383例室性心律失常病例中，选出在不同阶段出现室行早搏的217例患者进行分析。结果：经冠状动脉造影证实确定为冠心病的174例，高血压性心脏病合并冠心病12例，X综合症4例，心律失常15例，植物神经功能紊乱12例。174例冠心病患者7例为左主干病变，58例为双支病变，109例为单支病变。结论：平板运动试验对室性心律失常的定性分析具有较高的临床价值。     

急性颅脑损伤早期血浆CNP和脑脊液乳酸测定的临床意义

目的 :探讨了血浆C -型利钠多肽 (CNP)和脑脊液乳酸水平在急性颅脑损伤早期的病理、生理作用。方法 :分别应用放射免疫分析血浆CNP水平和生化法测定脑脊液乳酸水平。结果 :在治疗前颅脑损伤患者血浆CNP水平非常显著地低于正常人组 (p <0 0 1 ) ,脑脊液乳酸水平明显高于正常人水平 (p <0 0 1 ) ,治疗 1 5天后与正常人比较无显著差异 (p >0 0 5 )。 结论 :观察血浆CNP和脑脊液乳酸水平的变化对研究急性颅脑损伤早期的病理生理变化、判断疗效及预后观察具有十分重要的临床意义     

Cytocompatibility of Three Corneal Cell Types with Amniotic Membrane

Rabbit limbal corneal epithelial cells, corneal endothelial cells and keratocytes were cultured on amniotic membrane. Phase contrast microscope examination was performed daily. Histological and scan electron microscopic examinations were carried out to observe the growth, arrangement and adhesion of cultivated cells. Results showed that three corneal cell types seeded on amniotic membrane grew well and had normal cell morphology. Cultured cells attached firmly on the surface of amniotic membrane. Corneal epithelial cells showed singular layer or stratification. Cell boundaries were formed and tightly opposed. Corneal endothelial cells showed cobblestone or polygonal morphologic characteristics that appeared uniform in size. The cellular arrangement was compact. Keratocytes elongated and showed triangle or dendritic morphology with many intercellular joints which could form networks. In conclusion, amniotic membrane has good scaffold property, diffusion effect and compatibility with corneal cells. The basement membrane side of amniotic membrane facilitated the growth of corneal epithelial cells and endothelial cells and cell junctions were tightly developed. The spongy layer of amniotic membrane facilitated the growth of keratocytes and intercellular joints were rich. Amniotic membrane is an ideal biomaterial for layering tissue engineered cornea.     

中学生焦虑与其相关影响因素的综合研究

目的：综合探讨中学生焦虑状况与其相关影响因素的关系。方法：采用中学生焦虑量表、青少年生活事件量表、艾森克人格问卷、中学生父母教养方式量表和应对量表对558名中学生进行问卷调查。结果：(1)中学生整体的焦虑处于轻度水平，52．6％的学生存在不同程度的焦虑问题，男女生在焦虑水平上不存在较为明显的性别差异，年级差异在焦虑水平上表现也不明显。(2)中学生焦虑与生活事件、父母教养方式、人格和应对方式各因子均有十分显著的相关关系，进一步的回归分析结果表明有八个因素对焦虑的预测作用十分明显，具体为不良情绪应对、学习压力、神经质、父放任型教养方式、人际压力、母过分保护和干涉、解决问题和精神质。结论：中学生中存在较为明显的焦虑问题，多个因素对焦虑有预测作用。     

A double mutant [N543H+2393del9] allele in the LDL receptor gene in familial hypercholesterolemia: effect on plasma cholesterol levels and cardiovascular disease

Familial hypercholesterolemia is a genetic disorder caused by mutations in the LDL receptor gene. During a survey of mutations of LDL receptor gene in Spanish FH patients we found two mutations in the same allele: a missense N543H mutation in exon 11 and a 9bp inframe deletion (2393del9) located in exon 17. This double mutant allele was founded in 10 out of 458 unrelated patients: one homozygous FH [N543H+2393del9] + [N543H+2393del9], one compound heterozygote [N543H+2393del9] + [W-18X+E256K] and 8 heterozygotes. Flow cytometric analysis showed a defective LDL binding (20% of normal value) and internalization (23%) in lymphocytes from the homozygous patient; furthermore, studies of mitogen-stimulated lymphocytes demonstrated that the ability of LDL to support cell proliferation was impaired. Unexpectedly, not all carriers of the double mutant allele develop hypercholesterolemia and, furthermore, cholesterol-lowering treatment of the homozygous patient resulted in a 58% LDL cholesterol reduction. In conclusion, the phenotypic expression in the homozygous and heterozygous patients presented here, as well as the LDL-receptor residual activity, allowed the classification of this mutation as mild extending the group of mild mutations found at homozygosity.     

IL-13对小鼠哮喘模型气道黏蛋白基因Muc5ac及Bcl-2、Bax表达的作用

目的研究白细胞介素-13(IL-13)处理小鼠支气管哮喘(哮喘)模型前后肺组织黏蛋白基因Muc5ac、凋亡相关蛋白Bcl-2和Bax表达的作用,探讨气道黏液过度分泌的机制.方法45只雄性BALB/c小鼠随机分为对照组、哮喘组和IL-13组,每组15只.用逆转录-聚合酶链反应(RT-PCR)方法和免疫组化法分别检测Muc5acmRNA、Muc5ac蛋白、Bcl-2蛋白以及Bax蛋白在肺组织的表达.结果哮喘组和对照组肺组织Muc5acmRNA分别为(0.1552±0.0057)和(0.0633±0.0013),Muc5ac蛋白分别为(0.8849±0.0257)和(0.1166±0.0064),两组比较差异均有统计学意义(P<0.01);IL-13组肺组织Muc5acmRNA和蛋白分别为(0.2807±0.0027)和(1.6138±0.0483),与哮喘组、对照组比较差异也均有统计学意义(P均<0.01).与对照组Bcl-2蛋白(0.3279±0.0136)、Bax蛋白(1.7284±0.0263)相比,哮喘组分别增加和降低(分别为0.8383±0.0310和0.8987±0.0106),两组差异均有统计学意义(P均<0.01);IL-13处理后可分别促进Bcl-2和Bax蛋白增加和降低(分别为1.6934±0.0229和0.3522±0.0152),其和哮喘组的差异均有统计学意义(P均<0.01);哮喘组和IL-13组小鼠肺组织Muc5acmRNA、蛋白表达与Bcl-2蛋白表达均呈直线正相关(P均<0.05),而与Bax蛋白表达则均呈直线负相关(P均<0.05).结论IL-13是引起哮喘气道黏液过度分泌的重要细胞因子,它可能通过改变Bcl-2和Bax的表达导致了上述病变.     

体外厌氧条件下载铜蒙脱石杀菌效果的研究

载铜蒙脱石的杀菌作用通过脑心浸液肉汤 (BHI)二倍系列稀释法来判定其最小抑菌浓度 (MIC)。释放入肉汤和生理盐水中Cu2 的量通过原子吸收光谱仪测定。杀菌动力学研究采用改良的振荡瓶法。结果表明 :厌氧条件下 ,载铜蒙脱石具有很强的杀菌性能。载铜蒙脱石对放线共生放线杆菌的最小抑菌浓度为 2 .5 6mg/ml;对血液链球菌为 5 .12mg/ml。测得肉汤二倍稀释的载铜蒙脱石释放出的Cu2 量在 2 .39～ 38.6 5 ppm之间 ,在生理盐水中释放的Cu2 量为 1.85～ 15 .82ppm。本试验结果表明 ,蒙脱石无抗菌性能。     

Mg^2＋对离体灌流内皮素的大鼠心脏功能的影响

本实验在离体大鼠心脏灌流模型上,观察到10~(-9)mol/L内皮素灌流引起心肌挛缩,心功能降低,冠脉灌流量减少,以及心肌Ca~(2 )聚积,Mg~(2 )丧失等表现。灌流液含低镁(0.12mmol/L)时内皮素对心脏的上述作用显著增强,而在含高镁(4.8mmol/L)时明显减弱。Mg~(2 )影响内皮素对心脏作用的机制可能与其抑制心肌Ca~(2 )内流有关。实验结果提示避免缺镁,适当补充Mg~(2 )对于防治伴有循环内皮素水平增加的疾病或病理过程中的心脏损伤可能具有临床意义。     

应用单克隆抗体测定纤维连结蛋白ELISA方法的建立

本文介绍用McAb作为包被和检测抗体进行双抗体夹心ELISA来测定人血浆纤维连结蛋白。通过实验找出最佳条件,即两种McAb混合使用,在McAb和酶结合物稀释液内加入4％PEG及使用TMBI底物的最适浓度等,该法敏感性可达80ng/ml,可作为临床常规方法使用。