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Abstract@#Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.
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Objective To investigate the influence of intrahepatic cholestasis of pregnancy (ICP) on adverse pregnancy outcomes of hepatitis B virus (HBV)-infected pregnant women. Methods A retrospective analysis was performed for 232 pregnant women with chronic HBV infection who were admitted to Beijing YouAn Hospital, Capital Medical University, from March 2018 to March 2021. According to the presence or absence of ICP, the patients were divided into HBV infection group with 100 patients and HBV+ICP group with 132 patients; according to the severity of ICP, the patients in the HBV+ICP group were further divided into HBV+mild ICP group with 86 patients and HBV+severe ICP group with 46 patients. The above groups were compared in terms of the incidence rates of maternal complications during pregnancy, such as premature delivery, premature rupture of membranes, gestational diabetes mellitus, hypertensive disorder complicating pregnancy, and postpartum hemorrhage (PPH), as well as the adverse outcomes of fetus/neonate, such as intrauterine fetal death, neonatal asphyxia, amniotic fluid pollution degree Ⅲ(AFⅢ), neonatal respiratory distress syndrome, small-for-gestational-age (SGA), admission to the neonatal intensive care unit, pneumonia, and mother-to-child transmission (MTCT) of HBV. A one-way analysis of variance was used for comparison between multiple groups; the chi-square test, the chi-square test with continuity correction or the Fisher's exact test was used for comparison of categorical data between multiple groups. Results Compared with the HBV infection group in terms of maternal complications in late pregnancy, the HBV+ICP group had significantly higher incidence rates of premature delivery and PPH ( χ 2 =4.169 and 5.448, P =0.041 and 0.020), and in terms of the adverse outcomes of neonates, the HBV+ICP group had significantly higher incidence rates of neonatal asphyxia, AFⅢ, and SGA than the HBV infection group ( χ 2 =5.448, 16.567, and 11.053, P =0.020, P < 0.001, and P =0.002). In terms of the adverse outcomes of neonates, the HBV+severe ICP group had significantly higher incidence rates of AFⅢ and SGA than the HBV+mild ICP group ( χ 2 =4.200 and 4.511, P =0.040 and 0.034). Conclusion Compared with the pregnant women with HBV infection alone, the pregnant women with HBV infection and ICP have significantly higher incidence rates of adverse pregnancy outcomes in mothers and neonates, and the incidence rate of adverse outcomes in neonates increases with the increase in the severity of ICP. However, ICP has no influence on HBV MTCT.
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Background/Aims@#To investigate postpartum hepatic flares and associated factors in highly viremic pregnant patients in the immune tolerance phase who adopted telbivudine (LdT) treatment in the last trimester to reduce vertical transmission of hepatitis B virus. @*Methods@#Hepatitis B e antigen (HBeAg)-positive, highly viremic pregnant women were recruited for this prospective study. Treatment with LdT was started from 28 weeks of gestation. Virological and biochemical markers were examined before LdT treatment, antepartum and postpartum. Serial blood samples at the same time were collected to detect cytokines and cortisol (COR). @*Results@#Fifty-six of 153 patients (36.6%) had postpartum hepatic flares, defined as a 2-fold increase in alanine aminotransferase 6 weeks after delivery. Age and the antepartum alanine aminotransferase and postpartum HBeAg levels were independent influencing factors of postpartum hepatic flares. Cytokines showed no regularity during or after pregnancy. Compared with the patients with no postpartum flares, the patients with flares had lower baseline interferon γ and COR levels (p=0.022 and p=0.028) and higher postpartum interferon γ levels (p=0.026). @*Conclusions@#A high proportion of highly viremic and immune-tolerant pregnant patients treated with LdT in the last trimester had postpartum hepatic flares, which implied that these patients entered the immune clearance phase after delivery. Thus, this may create an appropriate opportunity for re-antiviral therapy.
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Objective:To study the influence of different feeding patterns on mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in pregnant women with high viral loads who received antiviral medication during pregnancy to the day of delivery.Methods:This prospective cohort study was conducted in Beijing You'an Hospital. From January 1, 2019, to March 31, 2020, and 574 pregnant women with positive hepatitis B surface antigen (HBsAg) and HBV DNA>2×10 5 IU/ml were enrolled. All participants received tenofovir, telbivudine, lamivudine, or propofol tenofovir from 24-28 weeks of gestation and discontinued on the day of delivery, and their neonates were postnatally given routine passive-active immunoprophylaxis. Based on the feeding patterns, the subjects were divided into three groups: breastfeeding ( n=257), bottle-feeding ( n=241) and mixed feeding groups ( n=76). The follow-up data were obtained from liver functions and HBV DNA level of the mothers at 6-8 weeks postpartum and HBV serological markers of infants at 7-12 months. One-way ANOVA, Student-Newman-Keuls, Chi-square test or Fisher exact test, and repeated measures ANOVA were used to analyze the data. Results:The average maternal HBV DNA levels before antiviral treatment did not differ significantly between the three groups [(7.90±0.67), (7.82±0.70), (7.83±0.70) log 10 IU/ml, F=0.912, P>0.05]. HBV DNA level before delivery in the mixed feeding group was slightly lower than that in the breastfeeding and bottle-feeding group [(3.87 ±1.08) vs (4.21±1.17) and (4.30±1.28) log 10 IU/ml, q= 3.052 and 3.831, both P<0.05], while the comparison between the latter two groups showed no significant differences ( P>0.05). After delivery, HBV DNA level in the bottle-feeding group was slightly lower than that in the breastfeeding group [(7.42±0.93) vs (7.69±0.90) log 10 IU/ml, q=4.583, P<0.05]. Among 580 infants (including six pairs of twins), only one bottle-fed infant (0.4%, 1/243) was infected with HBV through MTCT, and none in the breastfeeding or mixed feeding group ( P=0.553). Conclusions:For pregnant women with high viral loads of HBV who have received antiviral medication during pregnancy, although HBV DNA level will rebound after discontinuation upon delivery, breastfeeding is recommended considering it does not increase the risk of MTCT.
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Major depressive disorder(MDD) is a kind of mental disorder with depression and decreased interest as the main clinical manifestations. The pathogenesis of MDD is unclear, and MDD is characterized by high incidence, high recurrence rate and high suicide rate. At present, the hypothesis of monomamine mechanism can not fully clarify its pathological characteristics, and a considerable number of patients with depression do not respond well to existing antidepressants. N-methyl-D-aspartate receptor (NMDAR) antagonist and γ-aminobutyric acid A(GABAA) receptor positive allosteric regulator have a potential rapid antidepressant effect, which may be a breakthrough in the pathogenesis and clinical treatment of depression. NMDAR has bidirectional regulation, when proper activation of NMDAR can promote dendrite development, neuronal growth and long-term potentiation, but overstimulation of NMDAR can cause toxic reaction, leading to synaptic atrophy and neuronal death. In addition, inflammation can induce changes in NMDAR function and lead to depressive symptoms. At present, ketamine, a new antidepressant NMDAR antagonist, may plays a role in rapid antidepressant and delayed recurrence of depression by increasing the release of BDNF, activating the signal pathway of mammalian target of rapamycin complex 1(mTORC1), and promoting protein synthesis and synaptic plasticity. Thus, ketamine has the effect of rapid antidepressant and delaying the recurrence of depression. However, due to the large variability of NMDAR gene in patients with MDD, its potential functional polymorphism affects clinical symptoms and drug sensitivity. Therefore, by analyzing the latest research at home and abroad, this review comprehensively summarizes the pathogenesis of NMDAR dysfunction, the pathogenesis of MDD, antidepressant treatment and clinical application status, in order to provide theoretical basis for clinical accurate treatment of MDD patients in the future.
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Objective@#To study the prevalence of taste alteration and the changes of life quality with nasopharyngeal carcinoma patients during radiotherapy period, then analyze the correlation between them.@*Methods@#Sixty patients with nasopharyngeal carcinoma in Zhejiang Cancer Hospital from October 2018 to February 2019 were interviewed during radiotherapy period, Chemotherapy-induced Taste Alteration Scale and European Organization for Research and Treatment of Cancer-quality of life head and neck module were used at four times points, which were the beginning of radiotherapy,10 F and 20 F after radiotherapy, and the end of radiotherapy.@*Results@#The score of taste alteration at the beginning of radiotherapy,10 F and 20 F after radiotherapy, and the end of radiotherapy were 22.02 ± 0.60, 45.85 ± 2.27, 55.75 ± 2.21, 63.7 ± 2.13, the life quality score at the beginning of radiotherapy,10 F and 20 F after radiotherapy, and the end of radiotherapy were 7.59 ± 0.84, 25.68 ± 2.00, 35.86 ± 2.43, 44.84 ± 2.73, both were significantly different(F=131.43, 116.85, all P<0.01). Spearman correlation analysis showed that there were positive correlation between taste alteration and quality of life(r=0.244-0.674, all P<0.05 or 0.01).@*Conclusions@#The main finding of this study is that taste impairment in nasopharyngeal carcinoma patient was increased as the radiotherapy continues, and the correlation between quality life and taste alteration was significantly enhanced, which should be afforded greater attention from medical staff.
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Objective@#Many physicians and patients still have concerns about the safety of breastfeeding in mothers infected with hepatitis B virus; we evaluate the safety of the newborn and the women with HBeAg positive and high viral load, who received nucleoside analogues to block maternal to child transmisssion and selected postpartum breastfeeding after drug discontinuance.@*Methods@#This prospective, observational study enrolled 60 HBeAg positive patients and HBV-DNA >2*10E+ 5 IU/ml, all patients started antiviral treatment for blocking maternal to child transmission at 24-28 weeks of pregnancy. All the newborns received the active-passive immunization therapy with hepatitis B immunoglobulin (HBIG) and HBVac. After the delivery, patients with normal liver function discontinued the antiviral drug and selected breastfeeding voluntarily. The safety of breastfeeding were compared with patients selected artificial feedings, they were followed up for 7 months. Primary measurements were the proportion of mothers with abormal liver function after stopping the drug and the level of newborn’s anti-HBs at 6 months of age; secondary measurements were the positive rate of neonatal HBsAg and the HBV-DNA value of the patients at 6 weeks postpartum.@*Results@#From December 1, 2015 to May 1, 2017, 415 patients were enrolled in Beijing You’an Hospital Affiliated to the Capital Medical University and all these patients were born following full-term single-child pregnancy. After the delivery and drug withdrawal, there was no significant difference in the incidence of ALT elevation between the breast fed group and the artificially fed group: 29 /220 versus 30/195, (χ2=0.411, P=0.521). Patients continued to take the antiviral medicines between the breast feeding group and the artificial feeding group: 15 /220 versus 20/195, (χ2=1.487, P=0.223), there were no significant differences between them (P> 0.05). At the month 7, there were no significant difference between the breast fed group and the artificially fed group (747.62±374.08 mlU/ml versus 709.76±374.32 mlU/ml, t-value: 0.309, P-value>0.05). At birth, hepatitis B surface antigen (HBsAg) was detected in 15/220 and 20/195 of newborns in the breast feeding and artificially fed groups, respectively. At month 7, an intention-to-treat analysis indicated 0/220 of HBsAg infants from the breast fed versus 0/195 in the artificially fed group (P>0.05) and no significant difference was found in the rate of positive HBsAg between the two groups. In the breast fed group, the mean HBV DNA at baseline was significantly higher than that of the artificially fed group: (1.17±1.82) E+ 8 IU/ml versus (1.12±0.39)E+ 8 IU/ml, and the difference was statistically significant.@*Conclusions@#We have not found the relationship between the rate of neonatal infection and the increase of maternal abnormal liver function in HBeAg positive and high viral load patients, who chose breastfeeding after drug discontinuance.
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Cancer-related fatigue(CRF) is one of the important symptoms for cancer patients,especially for the long-term survival patients after treatment.Its complexity and interdependency with other symptoms make it difficult to identify the clear underlying mechanisms. No single etiologic model provides a satisfactory explanation of cancer-related fatigue.For mild fatigue,non-pharmacological therapy is recommended.Non-pharmacological therapy combined with pharmacological therapies is recommended for patients with moderate and severe fatigue.
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<p><b>OBJECTIVE</b>To determine whether smoking increases the risk for developing metabolic syndrome (MetS) in Chinese men.</p><p><b>METHODS</b>A total of 693 men with no MetS at baseline were followed for 2.9-5.5 years. Subjects were divided into nonsmokers, ex-smokers, and current smokers according to baseline smoking status.</p><p><b>RESULTS</b>After adjusting for age, education level, alcohol intake, fasting plasma insulin, HOMA-IR index, and BMI at baseline and weight change, current smokers were dose-dependently associated with increased risk for developing new MetS compared with nonsmokers. The odds ratio (OR) was 2.131 (95% CI, 1.264, 3.592; P<0.01) for the NCEPIII definition or 3.083 (95% CI, 1.807, 5.295; P<0.01) for the JCDCG definition of MetS. Ex-smokers who had quit for ≥13 years significantly decreased the risk for developing new MetS defined by the JCDCG definition. Compared with nonsmokers, current smokers were significantly associated with increased incidence of hypertriglyceridemia and low HDL-C.</p><p><b>CONCLUSION</b>Smoking is a risk factor for developing MetS in Chinese men after adjusting for age, education level, alcohol intake, fasting plasma insulin, HOMA-IR, BMI, and weight change. This could be due to an increased incidence of dyslipidemia. Smoking cessation for >13 years decreased the risk for developing MetS defined by the JCDCG definition.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Blood Glucose , Metabolism , Body Mass Index , China , Epidemiology , Cholesterol, HDL , Blood , Diabetes Mellitus , Blood , Epidemiology , Follow-Up Studies , Hypertriglyceridemia , Blood , Epidemiology , Metabolic Syndrome , Blood , Epidemiology , Odds Ratio , Risk Factors , Smoking , Blood , Epidemiology , Waist CircumferenceABSTRACT
<p><b>OBJECTIVE</b>To investigate the status of the semen of the infertility patients infected by Gardnerella vaginalis (Gv).</p><p><b>METHODS</b>Semen samples from 373 clinic patients of infertility and vaginal samples from 63 positive patients' wives were collected from April 2002 to May 2003. And the samples were tested by nested polymerase chain reaction (nPCR).</p><p><b>RESULTS</b>The positive rate of the infertile males' semen infected by Gv was 44.2%, while that of the postive patients' wives was 87.3%.</p><p><b>CONCLUSION</b>The positive rate of the infertile male's semen infected by Gv is high and Gv can be spread by sexual intercourse.</p>