[Diagnosis and treatment procedures and health management for patients with hereditary angioedema].

As a recognized rare and highly fatal disease, hereditary angioedema (HAE) is difficult to diagnose and characterized by recurrent edema involving the head, limbs, genitals and larynx, etc. Diagnosis of HAE is not difficult. However, low incidence and lack of clinical characteristics lead to difficulty of doctors on timely diagnosis and correct intervention for HAE patients. Therefore, it is crucial to improve the awareness of this disease and prevent its recurrence. for HAE patients. In view of absent cognition of doctors and the general public on HAE, patients often suffer from sudden death or become disabled due to laryngeal edema which cannot be treated in time. Thus, based on the Internet mobile terminal platform, the team set up an all-day rapid emergency response system which is provided for HAE patients by setting up "one-click help". The aim is to offer optimization on overall management of HAE and designed the intelligent follow-up management to provide timely assistance and specialized suggestion for patients with acute attacks.

[Preliminary insights into the practice of hypoallergenic home visiting program].

Allergic diseases affect about 40% of the world's population. Environmental factors are important in the occurrence and development of allergic diseases. Dust mites are one of the most important allergens in the indoor environment. The World Health Organization proposes the "four-in-one, combination of prevention and treatment" treatment principle for allergic diseases, in which environmental control to avoid or reduce allergens is the first choice for treatment. Modern people spend much more time at home (including sleeping) than outdoors, and the control of the home environment is particularly critical. This practice introduces the hypoallergenic home visit program, which including home environment assessment, environmental and behavioral intervention guidance, and common household hypoallergenic supplies and service guidance for the patient's home environment. The real-time semi-quantitative testing of dust mite allergens, qualitative assessments of other indoor allergens, record of patients' household items and lifestyle, and precise, individualized patient prevention and control education will be conducted. The hypoallergenic home visit program improves the doctors' diagnosis and treatment data dimension, and becomes a patient management tool for doctors outside the hospital. It also helps patients continue to scientifically avoid allergens and irritants in the environment, effectively build a hypoallergenic home environment, reduce exposure to allergens in the home environment, and achieve the goal of combining the prevention and treatment of allergic diseases.

[A comparative study of artificial intelligence nasal polyp classification based on whole-slide imaging and JESREC diagnostic criteria].

Objective: To explore the types and clinical characteristics of chronic rhinosinusitis with nasal polyps (CRSwNP) based on artificial intelligence and whole-slide imaging (WSI), and to explore the consistency of the diagnostic criteria of the Japanese epidemiological survey of refractory eosinophilic chronic rhinosinusitis (JESREC) in Chinese CRSwNP patients. Methods: The data of 136 patients with CRSwNP (101 males and 35 females, aging 14 to 70 years) who underwent endoscopic sinus surgery from 2018 to 2019 in the Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University were analysed retrospectively. The preoperative clinical characteristics of patients were collected, such as visual analogue scale (VAS) of nasal symptoms, peripheral blood inflammatory cell count, total immunoglobulin E (IgE), Lund-Kennedy score and Lund-Mackay score. The proportion of inflammatory cells such as eosinophils, lymphocytes, plasma cells and neutrophils were calculated on the WSI of each patient through artificial intelligence chronic rhinosinusitis evaluation platform 2.0 (AICEP 2.0), and the specific type of nasal polyps was then obtained as eosinophilic CRSwNP (eCRSwNP) or non-eosinophilic CRSwNP (non-eCRSwNP). In addition, the JESREC diagnostic criteria was used to classify the nasal polyps, and the classification results were compared with the current gold standard for nasal polyps diagnosis (pathological diagnosis based on WSI). The accuracy, sensitivity and specificity of the diagnostic criteria of JESREC were evaluated. The data were expressed in M (Q1, Q3) and statistically analyzed by SPSS 17.0. Results: There was no significant difference between eCRSwNP and non-eCRSwNP in age distribution, gender, time of onset, total VAS score, Lund-Kennedy score or Lund-Mackay score. However, there was a significant difference in the ratio of nasal polyp inflammatory cells (eosinophils 40.5% (22.8%, 54.7%) vs 2.5% (1.0%, 5.3%), neutrophils 0.3% (0.1%, 0.7%) vs 1.3% (0.5%, 3.6%), lymphocytes 49.9% (39.3%, 65.9%) vs 82.0% (72.8%, 87.5%), plasma cells 5.1% (3.6%, 10.5%) vs 13.0% (7.4%, 16.3%), χ2 value was 9.91, 4.66, 8.28, 5.06, respectively, all P<0.05). In addition, eCRSwNP had a significantly higher level of proportion of allergic symptoms (nasal itching and sneezing), asthma, peripheral blood eosinophil and total IgE (all P<0.05). The overall accuracy, sensitivity and specificity of the JESREC diagnostic criteria was 74.3%, 81.3% and 64.3%, respectively. Conclusions: The eCRSwNP based on artificial intelligence and WSI has significant high level of allergic symptoms, asthma, peripheral blood eosinophils and total IgE, and the percentages of inflammatory cells in nasal polyps are different from that of non-eCRSwNP. The JESREC diagnostic criteria has good consistency in our research.

[Using the big data of internet to understand the characteristics of coronavirus disease 2019: a big data study].

Objective: To analyze the symptom characteristics of Coronavirus Disease 2019(COVID-19) and to improve its prevention by using big data. Methods: Using Baidu Index Platform (http://index.baidu.com) and the website of Chinese Center for Disease Control and Prevention as data resources, we obtained the search volume (SV) of keywords for symptoms associated with COVID-19 from January 1 to February 20 in each year from 2017 to 2020, in Hubei province and other top 10 impacted provinces in China and the epidemic data. Data of 2020 were compared with the previous three years. Data of Hubei province were compared with confirmed cases. The differences and characteristics of the SV of COVID-19-related symptoms, and the correlation between the SV of COVID-19 and new confirmed or suspected cases were analyzed and the hysteresis effects were discussed. R3.6.2 software was used to analyze the data. Results: Compared the data from January 1 to February 20, 2020, with the SV for the same period of previous three years, Hubei's SV for cough, fever, diarrhea, chest tightness, dyspnea and other symptoms were significantly increased. The total SV of lower respiratory symptoms was significantly higher than that of upper respiratory symptoms (P<0.001). The SV of COVID-19 in Hubei province was significantly correlated with new confirmed or suspected cases (r(confirmed)=0.723, r(suspected)=0.863, all P<0.001). The results of the distributed lag model suggested that the patients who retrieved relevant symptoms on the internet may begin to see a doctor in 2-3 days later and be diagnosed in 3-4 days later. Conclusions: The total SV of lower respiratory symptoms is higher than that of upper respiratory symptoms, and the SV of diarrhea also increases significantly. It warns us to pay attention to not only the symptoms of lower respiratory tract, but also the gastrointestinal symptoms, especially diarrhea in patients with COVID-19. There is a relationship between internet retrieval behavior and the number of new confirmed or suspected cases. Big data have a certain role in the early warning of infectious diseases.

[Clinical significance of serum allergen sIgE and peripheral blood EOS in patients with chronic sinusitis with nasal polyps].

Objective:To explore the influnces of allergen sIgE and peripheral blood eosinophilic(EOS) on the severity and surgical outcomes in patients with chronic rhinosinusitis with nasal polyps（CRSwNP）. Method:Eighty-nine patients with CRSwNP were enrolled. Before operation, allergen sIgE levels and peripheral blood EOS were detected.All patients were examined paranasal computed tomography(CT). After 3 and 6 months of operation, all patients were examined by nasal endoscopy，Allergen sIgE, peripheral blood EOS, nasal endoscopy score, and CT score were retrospective analyzed. According to the results of allergen sIgE the subjects were divided into two groups: the positive allergens group and negative allergens group. Result:Allergen sIgE were positive in 49 patients(the positive allergens group) and negative in 40 patients(the negative allergens group). The major allergens were Dermatophagoides pteronyssinus（39 patients） and cockroach（16 patients）. Between the positive allergens group and the allergens negative group, there were no statistically significant differences in peripheral blood EOS count and EOS percentage and CT scores and nasal endoscopy scores of 3-month postsurgery(P>0.05). There was signifigant diference in the nasal endoscopy scores of 6- month postsurgery between the two groups(P<0.05). In the 89 patients with CRSwNP, peripheral eosinophil count showed no significant correlation with CT image scores and 3-month postsurgery nasal endoscopy scores and 6-month postsurgery nasal endoscopy scores(r=0.119，0.180，0.126，P>0.05). Blood eosinophil percentage was not significantly correlated to CT image scores and 3-month postsurgery nasal endoscopy scores and 6-month postsurgery nasal endoscopy scores(r=0.167，0.263，0.140，P>0.05). Conclusion:Allergen sIgE has some impacts on postoperative outcomes but has no impact on the severity of CRSwNP. Peripheral eosinophil may not affect the severity and surgical outcomes of CRSwNP.

The relationship between tumour necrosis factor-α gene polymorphism and susceptibility and clearance of the persistent hepatitis B virus infection in a Chinese population: a meta-analysis.

To date, many studies conducted in the Chinese population have determined the correlation between the tumour necrosis factor-α (TNF-α)-238G/A, -308G/A, -857C/T and -863C/A polymorphisms and persistent hepatitis B virus (HBV) infection. However, their results remain inconclusive. With the aim of confirming this correlation, we performed a meta-analysis of 19 studies. The dichotomous data are presented as the OR with a 95% CI. The results of our study indicate that carriers of the TNF-α-857T allele among the pooled Chinese population were more likely to show spontaneous clearance of HBV (T vs C: OR = 0.824, 95% CI = 0.713-0.953, p 0.009; TT vs CC: OR = 0.701, 95% CI = 0.507-0.970, p 0.032; TC vs CC: OR = 0.804, 95% CI = 0.683-0.947, p 0.009; TT + TC vs CC: OR = 0.835, 95% CI = 0.716-0.974, p 0.021). The TNF-α-308A allele was associated with significantly reduced persistent HBV infection risk in the Chinese (A vs G: OR = 0.585, 95% CI = 0.456-0.751, p 0.002; AG vs GG: OR = 0.519, 95% CI = 0.341-0.789, p <0.000; AA + AG vs GG: OR = 0.512, 95% CI = 0.339-0.772, p 0.001). Persistent HBV infection susceptibility is associated with the TNF-α-308G/A gene polymorphism in the Chinese population, whereas HBV clearance is associated with the TNF-α-857C/T gene polymorphism.

The effects of the farnesyl transferase inhibitor FTI L-778,123 on normal, myelodysplastic, and myeloid leukemia bone marrow progenitor proliferation in vitro.

The effects of the farnesyl transferase inhibitor FTI-778,123 on the proliferation of normal, MDS, AML, and CML hemopoietic progenitor cells was studied. MDS myeloid and erythroid progenitors are significantly more sensitive to FTI than normal progenitors while AML myeloid progenitors may be somewhat more sensitive than normal progenitors. In contrast, no difference between CML and normal progenitors are detectable. These data strongly suggest that a trial of this agent in patients with MDS and perhaps in patients with AML is indicated.

Effects of cytokines on CD20 antigen expression on tumor cells from patients with chronic lymphocytic leukemia.

Anti-CD20 antibody is an established treatment for low-grade non-Hodgkin's lymphoma (NHL). Augmenting the expression of CD20 antigen on the tumor cells may increase the cell kill and therefore increase the effectiveness of the antibody. To study this, we incubated peripheral blood lymphocytes from CLL patients with the following cytokines: EPO, SCF, TNFalpha, TGFbeta, GMCSF, TPO, IL-1, IL-2, IL-3, IL-4, GCSF. CD20 expression was studied by flow cytometry at baseline, 24 and 72 h after exposure to these cytokines. Upregulation of CD20 antigen expression was observed with IL-4, TNFalpha and GMCSF.

[Influence of chronic sinusitis on middle ear function].

OBJECTIVE: To study the effect of range size and duration of chronic sinusitis on middle ear function. METHOD: Eustachian tube function, tympanogram and air hearing threshold were measured with an acoustic impedance audiometer and pure tone audiometer in 56 patients (112 ears). RESULT: Eustachian tube function was disturbed in 48.3% cases, tympanogram was abnormal in 42.0% cases, and air hearing threshold was increased in 33.9% cases. Comparison of middle ear function between anterior sinusitis and pan-sinusitis showed significant difference (P < 0.01), middle ear function between the course of less 5 years and of more than 5 years had significant difference (P < 0.05). CONCLUSION: The damage of middle ear function become more serious with the extent of lesion and with the longer course of disease in paranasal sinuses.

[Bacteriological analysis of chronic sinusitis in school-age children (36 cases report)].

OBJECTIVE: To research the bacteriological characters of chronic sinusitis in school-age children and to provide basis for clinical treatment. METHOD: The purrent discharges taken from middle meatus of 36 patients were cultured for bacteria and the antimicrobial suscepility was determined. RESULT: The positive rate of bacteria culture was 83.3%, the compound infection rate was 36.1%. Aerobic bacteria were present in 76.7%, anaerobic bacteria were present in 55.6%. The result of antimicrobial susceptibility test was scattered. CONCLUSION: Infection rate of anaerobic bacteria was high in chronic sinusitis in school-age children and result of antimicrobial susceptibility was scattered. It was important to have anti-anaerobic treatment in chronic sinusitis in school-age children and to take an antimicrobial susceptibility test before medical treatment.

[Effects of intra-operative colonic irrigation on colonic flora in patients with intestinal obstruction caused by left colonic carcinomas].

We studied the effects of intra-operative colonic irrigation on intestinal bacteria in patients with carcinomatous obstruction of the left colon. The results showed: The floral volume of aerobes and anaerobes in colonic content and mucosa in obstructive patients increased significantly (P < 0.01), but it was reduced obviously by intra-operative colonic irrigation (P < 0.01), reaching the level of that as in the nonobstructive patients who received oral antibiotics and mechanical intestinal preparation.

Specific antitumor immunologic reactivity in patients with retinoblastoma.

Retinoblastoma antigen (RbAg) and retinal tissue antigen (RAg) were made from allogeneic retinoblastoma tissues and normal retinal tissue using the 3M KCl method. We have examined leukocyte migration inhibition test (LMIT) and enzyme-linked immunosorbent assay (ELISA) to RbAg and RAg in normal controls and the patients with retinoblastoma, including two spontaneously regressed cases. In LMIT, six out of the 11 patients tested against RhAg showed positive reactivity, in which 4 cases reacted only with RbAg, but not with RAg. All nine control subjects had negative reactivity to the two antigens. In ELISA, 40% of the retinoblastoma patients and 5.56% in normal controls showed positive reaction against RbAg. It was suggested that not only retinal antigens but also retinoblastoma specific antigens present in human retinoblastoma cells. The results also suggested that patients with retinoblastoma and those with spontaneous regression of Rb had both cell-mediated immunologic reactivity and humoral immune response toward retinoblastoma antigen in vitro. These immune responses to RbAg may be responsible for spontaneous regression of retinoblastoma.

Humoral and cellular immune responses to lens protein in patients with congenital cataract.

In order to understand the immune responses to lens protein in patients with congenital cataract, the passive hemagglutination assay for humoral immunity and the leukocyte migration test for cellular immunity to lens protein were performed on 43 patients with congenital cataract and 30 healthy persons served as control. The results showed that there was no significant difference in the incidence of humoral immune responses to lens protein between patients with congenital cataract and the controls (P greater than 0.05), but the incidence of cellular immune responses to lens protein in patients with congenital cataract was higher than that of the controls (P less than 0.005). The results of this study suggested that during the development of congenital cataract, lens protein leaked into the aqueous humour and entered the systemic circulation, sensitizing lymphocytes and producing cellular mediated immune responses. Further investigation is necessary to determine whether there is any relationship between the immune responses to lens protein and the formation of congenital cataract.