A real world study of anti-IgE monoclonal antibody in the treatment of allergic united airway disease / 中华预防医学杂志

Objective: To investigate the clinical efficacy and safety of anti-IgE monoclonal antibody (omazumab) in the treatment of allergic united airway disease (UAD) in the real-wold. Methods: Retrospective cohort study summarizes the case data of patients with allergic united airway disease who were treated with anti IgE monoclonal antibody (omalizumab) for more than 16 weeks from March 1, 2018 to June 30, 2022 in the Peking University First Hospital.The allergic UAD is defined as allergic asthma combined with allergic rhinitis (AA+AR) or allergic asthma combined with chronic sinusitis with nasal polyps (AA+CRSwNP) or allergic asthma combined with allergic rhinitis and nasal polyps (AA+AR+CRSwNP). The control of asthma was evaluated by asthma control test (ACT), lung function test and fractional exhaled nitric oxide (FeNO). The AR was assessed by total nasal symptom score (TNSS). The CRSwNP was evaluated by nasal visual analogue scale (n-VAS), sino-nasal outcome test-22 (SNOT-22), nasal polyps score (TPS) and Lund-Mackay sinus CT grading system. The global evaluation of omalizumab for the treatment of allergic UADwas performed by Global Evaluation of Treatment Effectiveness(GETE).The drug-related side effects were also recorded. Matched t test and Wilcoxon signed-rank test were used to compare the score changes of IgE monoclonal antibody (omazumab) before and after treatment, and multivariate logistic regression analysis was used to determine the influencing factors of IgE monoclonal antibody (omazumab) response. Results: A total of 117 patients with UAD were enrolled, ranging in age from 19 to 77 years; The median age of patients was 48.7 years; Among them, 60 were male, ranging from 19 to 77 years old, with a median age of 49.9 years; There were 57 females, ranging from 19 to 68 years old, with a median age of 47.2 years. There were 32 cases in AA+AR subgroup, 59 cases in AA+CRSwNP subgroup, and 26 cases in AA+AR+CRSwNP subgroup. The total serum IgE level was 190.5 (103.8,391.3) IU/ml. The treatment course of anti IgE monoclonal antibody was 24 (16, 32) weeks. Compared with pre-treatment, omalizumab increased ACT from 20.0 (19.5,22.0) to 24.0 (23.0,25.0) (Z=-8.537, P<0.001), increased pre-bronchodilator FEV1 from 90.2 (74.8,103.0)% predicted value to 95.4 (83.2,106.0)% predicted value (Z=-5.315,P<0.001), increased FEV1/FVC from 80.20 (66.83,88.38)% to 82.72 (71.26,92.25)% (Z=-4.483,P<0.001), decreased FeNO from(49.1±24.8) ppb to (32.8±24.4) ppb (t=5.235, P<0.001), decreased TNSS from (6.5±2.6)to (2.4±1.9) (t=14.171, P<0.001), decreased n-VAS from (6.8±1.2) to (3.4±2.0)(t=14.448, P<0.001), decreased SNOT-22 from (40.0±7.9) to (21.3±10.2)(t=15.360, P<0.001), decreased TPS from (4.1±0.8) to (2.4±1.0)(t=14.718, P<0.001) and decreased Lund-Mackay CT score from (6.0±1.3) to (3.1±1.6)(t=17.012, P<0.001). The global response rate to omalizumab was 67.5%(79/117). The response rate in AA+AR (90.6%,29/32) was significantly higher than that in AA+CRSwNP (61.0%,36/59) and AA+AR+CRSwNP (53.8%,14/26) subgroups (χ2=11.144,P=0.004). Only 4 patients (3.4%,4/117) had mild side effects. Conclusion: The real-world study showed favorable effectiveness and safety of anti-IgE monoclonal antibody for treatment of allergic UAD. To provide basis for preventing the progress and precise treatment of allergic UAD.

Neuronal Signatures of Negative and Positive Schemas towards the Self and Others in Patients with Early Stage Schizophrenia

Objective@#The present study investigated the functional neuroanatomy underlying negative and positive schemas towards the self and others in patients with early stage schizophrenia spectrum disorders (SSDs) using a task-based fMRI procedure. @*Methods@#This study included 50 patients with SSDs and 52 controls. The schema-evoking task consisted of four active conditions and neutral condition. Differences in brain activation were compared between the two groups. Correlation analysis was performed between task-related activation and psychopathology. @*Results@#The SSD patients exhibited higher activity of the left middle and inferior frontal gyri under the negative-others minus neutral contrast as well as greater activation of the left superior and middle frontal gyri and right medial superior frontal gyrus under the positive- self minus neutral and positive-others minus neutral contrasts. Under the positive-others minus neutral contrast, negative correlation was observed between activity of the right inferior parietal gyrus and right angular and total score of the Positive and Negative Syndrome Scale (PANSS), whereas positive correlation between activity of the left middle cingulate gyrus and left/right precuneus and positive-others score of the Brief Core Schema Scales (BCSS). @*Conclusion@#The present findings suggest that the frontal brain regions of SSD patients are more sensitive to negative and positive schemas towards the self and/or others compared to those of controls.

Neuronal Signatures of Negative and Positive Schemas towards the Self and Others in Patients with Early Stage Schizophrenia

Objective@#The present study investigated the functional neuroanatomy underlying negative and positive schemas towards the self and others in patients with early stage schizophrenia spectrum disorders (SSDs) using a task-based fMRI procedure. @*Methods@#This study included 50 patients with SSDs and 52 controls. The schema-evoking task consisted of four active conditions and neutral condition. Differences in brain activation were compared between the two groups. Correlation analysis was performed between task-related activation and psychopathology. @*Results@#The SSD patients exhibited higher activity of the left middle and inferior frontal gyri under the negative-others minus neutral contrast as well as greater activation of the left superior and middle frontal gyri and right medial superior frontal gyrus under the positive- self minus neutral and positive-others minus neutral contrasts. Under the positive-others minus neutral contrast, negative correlation was observed between activity of the right inferior parietal gyrus and right angular and total score of the Positive and Negative Syndrome Scale (PANSS), whereas positive correlation between activity of the left middle cingulate gyrus and left/right precuneus and positive-others score of the Brief Core Schema Scales (BCSS). @*Conclusion@#The present findings suggest that the frontal brain regions of SSD patients are more sensitive to negative and positive schemas towards the self and/or others compared to those of controls.

Research progress on application of machine learning in quality assurance of intensity-modulated radiotherapy / 中华放射肿瘤学杂志

In recent years,the application of machine learning in the field of radiotherapy has been gradually increased along with the development of big data and artificial intelligence technology.Through the training of previous plans,machine learning can predict the results of plan quality and dose verification.It can also predict the multi-leaf collimator (MLC) positioning error and linear accelerator performance.In addition,machine learning can be applied in the quality assurance of intensity-modulated radiotherapy to improve the quality and efficiency of treatment plan and implementation,increase the benefits to the patients and reduce the risk.However,there are many problems,such as difficulty in the selection,extraction and calculation of characteristic value,requirement for large training sample size and insufficient prediction accuracy,which impede its clinical translation and application.In this article,research progress on the application of machine learning in the quality assurance of IMRT was reviewed.

Polysaccharide extracts of Astragalus membranaceus and Atractylodes macrocephala promote intestinal epithelial cell migration by activating the polyamine-mediated K channel / 中国天然药物

Astragalus membranaceus (Radix Astragali, RA) and Atractylodes macrocephala (Rhizoma Atractylodis Macrocephalae, RAM) are often used to treat gastrointestinal diseases. In the present study, we determined the effects of polysaccharides extracts from these two herbs on IEC-6 cell migration and explored the potential underlying mechanisms. A migration model with IEC-6 cells was induced using a single-edged razor blade along the diameter of cell layers in six-well polystyrene plates. The cells were grown in control media or media containing spermidine (5 μmol·L, SPD), alpha-difluoromethylornithine (2.5 mmol·L, DFMO), 4-Aminopyridine (40 μmol·L, 4-AP), the polysaccharide extracts of RA or RAM (50, 100, or 200 mg·L), DFMO plus SPD, or DFMO plus polysaccharide extracts of RA or RAM for 12 or 24 h. Next, cytosolic free Ca ([Ca]) was measured using laser confocal microscopy, and cellular polyamine content was quantified with HPLC. Kv1.1 mRNA expression was assessed using RT-qPCR and Kv1.1 and RhoA protein expressions were measured with Western blotting analysis. A cell migration assay was carried out using Image-Pro Plus software. In addition, GC-MS was introduced to analyze the monosaccharide composition of both polysaccharide extracts. The resutls showed that treatment with polysaccharide extracts of RA or RAM significantly increased cellular polyamine content, elevated [Ca] and accelerated migration of IEC-6 cells, compared with the controls (P < 0.01). Polysaccharide extracts not only reversed the inhibitory effects of DFMO on cellular polyamine content and [Ca], but also restored IEC-6 cell migration to control level (P < 0.01 or < 0.05). Kv1.1 mRNA and protein expressions were increased (P < 0.05) after polysaccharide extract treatment in polyamine-deficient IEC-6 cells and RhoA protein expression was increased. Molar ratios of D-ribose, D-arabinose, L-rhamnose, D-mannose, D-glucose, and D-galactose was 1.0 : 14.1 : 0.3 : 19.9 : 181.3 : 6.3 in RA and 1.0 : 4.3 : 0.1 : 5.7 : 2.8 : 2.2 in RAM. In conclusion, treatment with RA and RAM polysaccharide extracts stimulated migration of intestinal epithelial cells via a polyamine-Kv1.1 channel activated signaling pathway, which facilitated intestinal injury healing.

Polysaccharide extracts of Astragalus membranaceus and Atractylodes macrocephala promote intestinal epithelial cell migration by activating the polyamine-mediated K channel / 中国天然药物

Astragalus membranaceus (Radix Astragali, RA) and Atractylodes macrocephala (Rhizoma Atractylodis Macrocephalae, RAM) are often used to treat gastrointestinal diseases. In the present study, we determined the effects of polysaccharides extracts from these two herbs on IEC-6 cell migration and explored the potential underlying mechanisms. A migration model with IEC-6 cells was induced using a single-edged razor blade along the diameter of cell layers in six-well polystyrene plates. The cells were grown in control media or media containing spermidine (5 μmol·L, SPD), alpha-difluoromethylornithine (2.5 mmol·L, DFMO), 4-Aminopyridine (40 μmol·L, 4-AP), the polysaccharide extracts of RA or RAM (50, 100, or 200 mg·L), DFMO plus SPD, or DFMO plus polysaccharide extracts of RA or RAM for 12 or 24 h. Next, cytosolic free Ca ([Ca]) was measured using laser confocal microscopy, and cellular polyamine content was quantified with HPLC. Kv1.1 mRNA expression was assessed using RT-qPCR and Kv1.1 and RhoA protein expressions were measured with Western blotting analysis. A cell migration assay was carried out using Image-Pro Plus software. In addition, GC-MS was introduced to analyze the monosaccharide composition of both polysaccharide extracts. The resutls showed that treatment with polysaccharide extracts of RA or RAM significantly increased cellular polyamine content, elevated [Ca] and accelerated migration of IEC-6 cells, compared with the controls (P < 0.01). Polysaccharide extracts not only reversed the inhibitory effects of DFMO on cellular polyamine content and [Ca], but also restored IEC-6 cell migration to control level (P < 0.01 or < 0.05). Kv1.1 mRNA and protein expressions were increased (P < 0.05) after polysaccharide extract treatment in polyamine-deficient IEC-6 cells and RhoA protein expression was increased. Molar ratios of D-ribose, D-arabinose, L-rhamnose, D-mannose, D-glucose, and D-galactose was 1.0 : 14.1 : 0.3 : 19.9 : 181.3 : 6.3 in RA and 1.0 : 4.3 : 0.1 : 5.7 : 2.8 : 2.2 in RAM. In conclusion, treatment with RA and RAM polysaccharide extracts stimulated migration of intestinal epithelial cells via a polyamine-Kv1.1 channel activated signaling pathway, which facilitated intestinal injury healing.

Application of machine learningin predicting the outcomes and complications of radiotherapy / 中华放射医学与防护杂志

Machine learning has developed rapidly in recent years.Using machine learning to predict the radiotherapy outcomes and complications can more accurately evaluate the patients' conditions and take appropriate treatment measures as soon as possible.The non-dose and dose related factors generated during radiotherapy are filtered and input into the algorithm model,then corresponding prediction result can be obtained.There are many algorithm models to predict survival rate,tumor control rate and radiotherapy complications,and the predicted result are more accurate now.However,the algorithm model also has various problems,and it needs constant exploration and improvement.

Approach to the management of hypothalamic pituitary function in patients with craniopharyngioma after operation / 中华内分泌代谢杂志

Craniopharyngiomas develop from remnant epithelial cells of Rathke's pouch in the sella/parasella region with low histological grade. Clinical manifestations are related to visual impairment, increased intracranial pressure, and hypothalamic/pituitary deficiencies, including vision loss, headache, nausea, growth retardation, and hypogonadism. Despite benign epithelial tumors, craniopharyngiomas are adjacent to critical brain structures including hypothalamus, pituitary stalk, chiasma opticum and have recurrence tendency. Treatment-related complications including hypothalamic/pituitary deficiencies, diabetes insipidus, and hypothalamic obesity are major risk factors for reduced quality of survival and throw out a great challenge to the surgical treatment and the postoperative management. Clinical features of one case craniopharyngiomas with manifestation of severe hypopituitarism are described with the aim of exploring effective therapies.

MRI features and pathological analysis of intracalvarium hemangioblastomas / 中国介入影像与治疗学

Objective To discuss MRI and pathological features of intracranial hemangioblastoma.Methods MRIdata of 26 cases of hemangioblastoma confirmed with operation and pathology were analyzed retrospectively.Results There were 22 cases with single lesion and multiple lesions in 4 eases.And a total of 31 lesions located in the posterior cranial fossa,including 14 lesions in right cerebellar hemispheres,9 lesions in left cerebellar hemispheres,2 lesions in cerebellar inferior vermis,4 lesions in medulla oblongata,and 2 lesions in fourth ventricle.Ninteen lesions showed cystic nodular type,1 lesion was cystic type,11 lesions showed parenchymal type or partial parenchyma type.Cystic lesions showed long T1 and long T2 signal,T1WI of solid area showed slightly long T1 and slightly long T2 signal,of which 12 lesions were slightly shorter T1 signal.Solid areas significantly enhanced,cystic area had no enhancement,but cystic wall of 3 cystic nodular lesions were slightly enhanced.DWI of solid areas showed low signal.MRS showed the peak of Cho obviously increased,and the peaks of Cr and NAA obviously decreased or nearly disappeared,and the high peak of lipids and lactate were observed.Conclusion The conventional and functional MRI of intracranial hemangioblastoma have some characteristics,MRI has a great value in the diagnosis and localization of intracranial hemangioblastoma.

MRI features and pathological analysis of intracalvarium hemangioblastomas / 中国介入影像与治疗学

Objective To discuss MRI and pathological features of intracranial hemangioblastoma.Methods MRIdata of 26 cases of hemangioblastoma confirmed with operation and pathology were analyzed retrospectively.Results There were 22 cases with single lesion and multiple lesions in 4 eases.And a total of 31 lesions located in the posterior cranial fossa,including 14 lesions in right cerebellar hemispheres,9 lesions in left cerebellar hemispheres,2 lesions in cerebellar inferior vermis,4 lesions in medulla oblongata,and 2 lesions in fourth ventricle.Ninteen lesions showed cystic nodular type,1 lesion was cystic type,11 lesions showed parenchymal type or partial parenchyma type.Cystic lesions showed long T1 and long T2 signal,T1WI of solid area showed slightly long T1 and slightly long T2 signal,of which 12 lesions were slightly shorter T1 signal.Solid areas significantly enhanced,cystic area had no enhancement,but cystic wall of 3 cystic nodular lesions were slightly enhanced.DWI of solid areas showed low signal.MRS showed the peak of Cho obviously increased,and the peaks of Cr and NAA obviously decreased or nearly disappeared,and the high peak of lipids and lactate were observed.Conclusion The conventional and functional MRI of intracranial hemangioblastoma have some characteristics,MRI has a great value in the diagnosis and localization of intracranial hemangioblastoma.

Relationship between Helicobacter pylori infection and histopathological features of nodular gastritis in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the relationship between Helicobacter pylori (Hp) infection and histopathological features of nodular gastritis (NG) in children.</p><p><b>METHODS</b>A total of 213 children who had undergone gastroscopy due to upper gastrointestinal symptoms were enrolled and were divided into NG and non-NG groups according to endoscopic appearance. The histopathological features of gastric mucosa were evaluated using the updated Sydney System. The rates of Hp infection, moderate to severe inflammation and lymphoid follicles formation of gastric mucosa were compared between the two groups.</p><p><b>RESULTS</b>Thirty-eight (17.8%) of the subjects were diagnosed with NG. The NG group had significantly increased rates of Hp infection (86.8% vs 14.3%; P<0.01), moderate to severe inflammation (81.6% vs 15.4%; P<0.01) and lymphoid follicles formation of gastric mucosa (52.6% vs 10.3%; P<0.01) compared with the non-NG group. NG had a high specificity (96.8%) and a positive predictive value (86.8%) for the diagnosis of Hp infection. NG was observed in 33 (56.9%) of 58 Hp-positive children and in 5 (3.2%) of 155 Hp-negative children (P<0.01). Hp-positive children had higher rates of moderate to severe inflammation (86.2% vs 5.2%, P<0.01) and lymphoid follicles formation of gastric mucosa (84.2% vs 14.9% P<0.01) compared with Hp-negative children. There were significant differences in Hp colonization, degree of inflammation and inflammation activity in gastric tissues between the NG and non-NG groups (P<0.01).</p><p><b>CONCLUSIONS</b>NG is a special sign of Hp infection in children, which mostly shows moderate to severe inflammation of gastric mucosa, and can be used as an endoscopic indicator of Hp infection. Hp eradication therapy should be considered in the treatment of NG.</p>

Approach to the patients with ectopic ACTH syndrome / 中华内分泌代谢杂志

Clinical features of 2 cases of ectopic ACTH syndrome with manifestation of severe hypercortisonism are described with the aim of exploring effective therapies.

Gene expression profile of the differentiation of mouse embryonic stem cells into pancreatic endocrine progenitor cells in vitro / 中华内分泌代谢杂志

Objective To investigate the implications of gene expression pattern of pancreatic endocrine differentiation from mouse embryonic stem cells (mES) in vitro.Methods Mouse ES cell line ES W9.5 was cultured and differentiated into pancreatic endoerine progenitor cells by using the stepwise differentiation strategy in vitro,then stage specific genes expression were tested by RT-PCR and immnunoeytochemistry.The Illumina Mouse Ref-8 vl.1 Expression BeadChips were used to compare the changes in the transcriptome of mES-derived differentiated cells on day4,8,15,20,22,25 after differentiation to undifferentiated mES cells.Results A total 86 differentially expressed genes,both up- and down-regulated,were found during the whole differentiation stage,6 gene clusters with the same developing patterns and differentially expressed genes in 6 groups were collected.By number,the most differentially expressed genes corresponded to posterior foregut stage( 201 genes) followed by definitive endoderm stage ( 17 genes).Conclusions The analysis of the genes with the same developing pattern and differentially expressed genes at each differentiation stage during pancreas development by microarray analysis provides some evidences of early embryonic and pancreatic development.

Study on hemorrhage following coblation assisted uvulopalatopharyngoplasty / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To compare the postoperative hemorrhage between standard uvulopalatopharyngoplasty (UPPP) and coblation assisted UPPP, and to evaluate the related risk factors and preventive measures.</p><p><b>METHODS</b>Five hundreds and ninety seven patients with obstructive sleep apnea hypopnea syndrome (OSAHS) underwent UPPP and coblation assisted UPPP between January 1, 1999, and September 30, 2009 were reviewed retrospectively. Two hundred and sixty three patients with coblation assisted UPPP and 334 patients with standard UPPP were treated respectively. Single factor statistic analysis, multiple factors Logistic regress statistic analysis and Wilcoxon test method for related risk factors were applied.</p><p><b>RESULTS</b>A total of 42 patients (7.0%) experienced postoperative bleeding. Among them, 24 patients with coblation assisted UPPP (9.1%) and 18 patients with UPPP (5.4%) had postoperative hemorrhage. Significant difference was not found in the degree of hemorrhage (z = 0.784, P > 0.05), hemorrhage site(χ(2) = 1.387, P > 0.05) and postoperative hemorrhage rates (χ(2) = 3.14, P > 0.05) between the two surgical techniques. Significant difference was found in the interval of hemorrhage after surgery between the two surgical techniques (χ(2) = 9.25, P < 0.01). History of hypertension, smoking, hepatic dysfunction was found to be correlated with the postoperative hemorrhage (Odd-ratio were respectively 7.326, 3.674, 2.707).</p><p><b>CONCLUSION</b>Coblation technique did not significantly increase UPPP postoperative hemorrhage.</p>

Clinical Characteristics of Functional Constipation Relating to Food Allergy in Infants / 实用儿科临床杂志

Objective To analyze the clinical characteristics of infants with functional constipation(FC)relating to food allergy(FA)and explore its ways of diagnosis and therapy.Methods The detail clinical information of the patients who corresponded to the criteria of diagnosis of FC and FA simultaneous from Mar.2007 to Dec.2009 were reviewed and analyzed.There were 496 cases of FA,in the FA joint clinic,gastroenterology clinic and pediatric ward,56 cases of them had the symptoms of FC(56/496 cases,11%),diets free and amino acid-based formulae were the treatments of the patients.The 56 cases were analyzed with skin-prick test(SPT),serum special IgE and serum special IgG,and the risk factors attributed to the no response to treatments with Logistic regression.Results Fifty-six cases opened the bowel less than twice a week,and companied with pain,8 patients with soiling once a week at least,10 patients with fecal retention,4 patients with large fecal in rectum.Mother or father with the history of allergy were 22 cases,17 cases,separately,both of mother and father with the history of allergy were 17 cases.The results of SPT,serum special IgE and serum special IgG showed that the patients with different allergens,cow's milk,egg,cod,especially.The patients with FC relating to FA were breast-feed,battle-feed or mix-feed.Treatment relied on amino acid-based formulae,as well as elimination diets in infants,80%of them(45/56 cases)improved.Introducing solid foods,the age of upsetting constipation and premature were the risk factors contributed to the no response to the diet free treatment.Conclusion FA should be consi-dered to contribute to the infants presenting with FC.Diets free and amino acid-based formulae may be effective.