Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain: a national multi-center survey of 35 566 population / 中华耳鼻咽喉头颈外科杂志

Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.

A guide to human microbiome research: study design, sample collection, and bioinformatics analysis / 中华医学杂志(英文版)

The purpose of this review is to provide medical researchers, especially those without a bioinformatics background, with an easy-to-understand summary of the concepts and technologies used in microbiome research. First, we define primary concepts such as microbiota, microbiome, and metagenome. Then, we discuss study design schemes, the methods of sample size calculation, and the methods for improving the reliability of research. We emphasize the importance of negative and positive controls in this section. Next, we discuss statistical analysis methods used in microbiome research, focusing on problems with multiple comparisons and ways to compare β-diversity between groups. Finally, we provide step-by-step pipelines for bioinformatics analysis. In summary, the meticulous study design is a key step to obtaining meaningful results, and appropriate statistical methods are important for accurate interpretation of microbiome data. The step-by-step pipelines provide researchers with insights into newly developed bioinformatics analysis methods.

Unilateral sinonasal disease in 376 adult patients: a retrospective study / 临床耳鼻咽喉头颈外科杂志

OBJECTIVES@#To investigate the clinical and pathological features of patients with unilateral sinonasal disease (USD).@*METHODS@#A retrospective analysis was completed on 376 adult patients with USD from January 2015 to December 2016. Their presenting symptoms, nasal endoscope, CT scanning, and pathology were analyzed respectively.@*RESULTS@#Among the 267 (71.01%) patients with inflammatory disease, there were 4 pathological types. And there were 8 pathological types in 60 (15.96%) patients with benign tumor. Of the 49 patients with malignant tumor, there were 15 pathological types which included squamous carcinoma, malignant melanoma, and lymphoma, as well as myoepithelial carcinoma and Mesodermal mesoderm. The onset age of inflammation group was younger than that of benign (<0.05) or malignant tumor groups (<0.05). The misdiagnosis rate was 8.33% in benign tumor (5/60), and 10.20% in malignant tumor (5/49). Nasal polyps was the most common misdiagnosis in the groups of benign and malignant tumor.@*CONCLUSIONS@#The pathology of adult patients with USD is complicated, and no specific clinical feature was found for distinguishing between benign and malignant lesions. The tumor took a quite proportion in adult patients with USD. Therefore, careful consideration should be taken before diagnosing patients with USD in order to reduce misdiagnosis rate.

Clinical and laboratory features of macrophage activation syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical and laboratory features of macrophage activation syndrome (MAS) at the early stage of diagnosis, and to explore a method for early identification of MAS.</p><p><b>METHODS</b>A retrospective analysis was performed for the demographic data, clinical and laboratory features, and treatment outcomes of 21 MAS patients.</p><p><b>RESULTS</b>Of the 21 MAS patients, 14 had systemic juvenile idiopathic arthritis, 5 had Kawasaki disease (KD), and 2 had connective tissue disease (CTD) as primary diseases. The median time of MAS onset was 19 days. The KD patients had the shortest time of MAS onset, while the CTD patients had the longest onset time (P=0.009). The top 10 clinical symptoms were fever (95%), rash (86%), lymph node enlargement (67%), hemophagocytic phenomenon in bone marrow (63%), pulmonary disease (62%), serous effusion (62%), hepatomegaly (52%), cerebrospinal fluid abnormalities (50%), central nervous system damage (43%), and splenomegaly (38%). The median of hemoglobin level was lower than the normal value. The medians of C-reactive protein level and erythrocyte sedimentation rate were higher than the normal values. There were significant increases in serum ferritin, glutamic-pyruvic transaminase, aspartate aminotransferase, lactate dehydrogenase, and triglyceride. The median of fibrinogen level was lower than the normal value. There were significant increases in D-dimer, interleukin-6 (IL-6), interleukin-10 (IL-10), and interferon-γ (IFN-γ). Of the 21 patients, 20 were improved and discharged.</p><p><b>CONCLUSIONS</b>If patients with rheumatic disease have persistent fever, hepatic dysfunction, coagulation disorders, multiple organ impairment, significantly increased IL-10 and IFN-γ, and a persistent increase in serum ferritin, the development of MAS should be considered.</p>

Association of vitamin D concentrations with juvenile idiopathic arthritis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>25-Hydroxyvitamin D3 [25(OH)D3] is the main product of vitamin D and can reflect the absolute concentration of active vitamin D in the body. This study examined serum 25(OH)D3 levels in children with juvenile idiopathic arthritis (JIA) in order to explore the association of vitamin D concentrations with the pathogenesis and disease activity of JIA.</p><p><b>METHODS</b>Serum samples were collected from 53 children confirmed as having JIA between January 2013 and March 2014, as well as 106 healthy children (control group) who underwent physical examination in the same period. Serum concentrations of 25(OH)D3 were measured using ELISA and compared between the cases and healthy controls. The association of serum 25(OH)D3 levels with JIA subtypes, ACR Pediatric 30 Score, peripheral blood C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were analyzed in children with JIA.</p><p><b>RESULTS</b>Compared with the control group, the JIA group had significantly reduced serum 25(OH)D3 levels (median: 42.6 nmol/L vs 49.9 nmol/L; P<0.01). The percentage of subjects with severe deficiency of vitamin D in the JIA group was significantly higher than that in the control group (17.0% vs 6.6%; P<0.05). Serum 25(OH)D3 showed no significant correlations with JIA subtypes, ACR Pediatric 30 Score, CRP, and ESR in children with JIA.</p><p><b>CONCLUSIONS</b>Vitamin D concentrations are significantly decreased in children with JIA. Decreased vitamin D concentrations may be associated with the pathogenesis of JIA. However, vitamin D concentrations may have no correlations with JIA subtypes, disease severity, and disease activity.</p>

Serum cytokine levels in children with newly diagnosed active systemic juvenile idiopathic arthritis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the changes in serum cytokines levels in children with newly diagnosed active systemic juvenile idiopathic arthritis (SJIA) and to explore the role of cytokines in the development and progression of SJIA.</p><p><b>METHODS</b>Seventy-four pediatric patients with active SJIA between January 2010 and December 2013 were included in the study. Serum levels of interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukine-10 (IL-10), tumor necrosis factor (TNF), and interferon gamma (IFN-γ) were measured by flow cytometry in these patients. The levels of cytokines were also determined in 202 healthy children as the control group. Routine laboratory parameters including white blood cell (WBC) count, percentage of neutrophils, hemoglobin level, platelet count, hypersensitive C-reactive protein (hs-CRP), and erythrocyte sedimentation rate (ESR) were monitored in the patient group.</p><p><b>RESULTS</b>The WBC count, percentage of neutrophils, hs-CRP, and ESR in 74 cases of SJIA were significantly above the normal range, their platelet counts were within the normal range, whereas hemoglobin levels were below the normal range. Compared with the control group, the patient group showed a significantly increased level of IL-6 (P<0.01) and significantly reduced levels of IL-4, IL-10, and TNF (P<0.01). However, there were no significant changes in serum levels of IL-2 and IFN-γ in the patient group (P>0.05). In SJIA children, IL-6 level, which was significantly elevated, was negatively correlated with hemoglobin level, which was significantly reduced (r=-0.244, P<0.05).</p><p><b>CONCLUSIONS</b>Serum level of IL-6 is significantly increased in children with SJIA, and it has a negative correlation with anemia.</p>

Risk factors for pleural lung disease in children with juvenile idiopathic arthritis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the risk factors for pleural lung disease (PLD) in children with juvenile idiopathic arthritis (JIA) and to provide a basis for the early diagnosis and timely treatment of this disease.</p><p><b>METHODS</b>A total of 360 children with a confirmed diagnosis of JIA were enrolled, and their clinical data were retrospectively analyzed. All patients underwent a chest X-ray. The patients with PLD were assigned to PLD group, while those without PLD were assigned to non-PLD group. The clinical, imaging, and laboratory results of JIA patients with PLD were analyzed.</p><p><b>RESULTS</b>Among the 360 JIA patients, 43 (11.9%) had PLD, and 9 (21%) of them had respiratory symptoms. Chest X-ray findings mainly included interstitial pneumonitis (53.5%) and pleurisy and/or pleural effusion (38.1%). In the 43 cases of JIA-PLD, 4 (9.3%) had normal chest X-ray findings but abnormal chest CT findings. The incidence of PLD was relatively high in patients aged under 3 years and those aged 12 years or above. Children with systemic JIA had a relatively high incidence of PLD. Compared with the non-PLD group, the PLD group had a significantly higher incidence of anemia, elevated white blood cell (WBC) count and IgG levels in peripheral blood, and positive rheumatoid factors or antinuclear antibodies (P<0.05).</p><p><b>CONCLUSIONS</b>Among children with JIA, PLD is mostly seen in patients with systemic JIA or aged <3 years or ≥ 12 years, especially those with anemia, elevated WBC count and IgG levels, and positive rheumatoid factors or antinuclear antibodies. For JIA patients with PLD, interstitial pneumonitis is usually seen on chest X-ray or CT, but respiratory symptoms are rarely observed. Routine use of high-resolution chest CT is recommended for early diagnosis and timely treatment of PLD in children with JIA.</p>

Nasal coblation plasma surgery for the treatment of persistent allergic rhinitis: an evaluation of short-term outcomes / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of nasal coblation plasma surgery for the treatment of persistent allergic rhinitis (PAR).</p><p><b>METHODS</b>One hundred patients with mite-sensitized moderate to severe PAR who underwent nasal coblation plasma surgery (inferior turbinoplasty plus nasal agger ablation) were enrolled in this study. There were 68 male and 32 female patients aged 16 to 62 years (mean, 36.3 years). The visual analogue scale (VAS) for global rhinitis symptoms, nasal provocation test (NPT), anterior rhinomanometry, and T&T olfactometry were used to assess the short-term outcomes, preoperatively and postoperatively at the end of three months after surgical procedure. SPSS19.0 software was applied for statistical analysis.</p><p><b>RESULTS</b>At three months after treatment, the total nasal symptom VAS scores significantly decreased from 7.0 ± 2.0 to 2.5 ± 1.5 (X(-) ± s; t = 18.00, P = 0.0001). All patients were allergic to house dust mites with positive NPT before treatment. At three months from the coblation intervention, 88.0% of the patients changed from positive NPT to negative, while 12.0% remained as positive. There was a significant reduction in total nasal resistance, which diminished from 0.772 ± 0.224 to 0.221 ± 0.112 kPa·s·L(-1) after treatment (t = 22.00, P = 0.0001). Preoperative olfactory tests showed hyposmia in 31.0% of the patients, with 22 cases for slight and 9 cases for moderate disorder. Three months after treatment, 13.0% were diagnosed as hyposmia, with 7 cases for slight and 6 cases for moderate disorder (χ(2) = 10.44, P = 0.005).</p><p><b>CONCLUSION</b>Nasal coblation plasma surgery provides favorable short-term outcomes in terms of remarkable improvement in nasal symptoms, hyperreactivity of nasal mucosa, nasal flow and olfactory function in patients with moderate to severe PAR, but long-term effect needed further observation.</p>

Evaluation of exposure and sensitization to house dust mites among rhinitis patients in the steppe environment of Inner Mongolia / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the correlation of exposure and sensitization to house dust mites among rhinitis patients, and the consistency of skin prick test (SPT) and serum specific IgE (sIgE) in the detection of sensitization in a steppe environment of inner Mongolia.</p><p><b>METHODS</b>Three hundreds and fourteen patients with rhinitis symptoms were recruited in this study in a hospital setting at Xilinhot City, inner Mongolia. All patients underwent medical history investigation, anterior rhinoscopy, and allergen tests in vivo (SPT) and in vitro (sIgE). Dust samples were collected from mattresses in patient's bedroom. The concentrations of group I major allergen of Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f) were measured by enzyme linked immunosorbent assay (ELISA). Statistical analysis was performed using a SPSS 17.0 software (t test, χ(2) test and so on).</p><p><b>RESULTS</b>Among a total of 314 patients, the prevalence of positive SPT for Der p and Der f was 5.7% and 22.0%, respectively; and the prevalence of positive sIgE for Der p and Der f was 9.2% and 7.6%, respectively. Sensitization rates for house dust mites (Der p and/or Der f) were lower than those of pollens. The pollen allergen with the highest positive rate was mugwort (SPT, 51.9%; sIgE, 47.1%). Diagnostic tests using SPT as the gold standard for sensitization showed that the positive likelihood ratio of sIgE was 4.27 for Der p and 10.64 for Der f, and the Kappa value was 0.20 for Der p and 0.35 for Der f, respectively. A total of 276 dust samples collected from patient's mattresses were measured. The concentrations of Der p 1 and Der f1 were detectable in 2 (0.7%) and 4 (1.4%) mattress samples, respectively. There was positive correlation between the exposure levels of Derp 1 and the SPT positive reaction to Der p (r(s) = 0.156, P = 0.01), but no significant correlation was found between the exposure levels of Der p 1 and the sIgE positive reaction to Der p (r(s) = 0.116, P = 0.055). There was no significant correlation between the exposure levels of Der f 1 and the SPT as well as sIgE positive reaction to Der f 1(r(s) = 0.05, P = 0.931; r(s) = 0.07, P = 0.245).</p><p><b>CONCLUSIONS</b>In the steppe environment of inner Mongolia, exposure to house dust mites are very low, and the Der p and Der f are not the major allergens in patients with allergic rhinitis. Also, it was not a simple dose-response relationship between exposure and sensitization to house dust mites. In such a specific environment, there is lower consistency between the results of SPT and sIgE in the detection of sensitization to house dust mites. Therefore, it is recommended that the allergen testing in vivo and in vitro should be combined for clinical diagnosis.</p>

Clinical features of systemic lupus erythematosus with pulmonary pleural lesion in children / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the clinical features of systemic lupus erythematosus (SLE) with pulmonary pleural lesion in children.</p><p><b>METHODS</b>One hundred and thirty three child patients with SLE admitted from 2001 to 2010 were enrolled in the study. The clinical data, chest X-ray findings and laboratory examination were retrospectively reviewed. Cases with infectious pulmonary pleural lesion were excluded.</p><p><b>RESULTS</b>According to chest X-ray findings pleural pulmonary lesions were involved in 45 out of 133 cases with SLE (33.83 %); however, only 30 cases (66.67 %) had positive respiratory manifestations. Respiratory features included cough and/or sputum (55.56 %), dyspnea and chest pain (15.56 % and 11.11 %), and only 28.89 % case with pleural pulmonary lesions had rales. Chest X-ray findings included pleural effusion/pleurisy (32 cases, 71.11%), bronchial pneumonia (21 cases, 46.67%) or interstitial pulmonary disease (13 cases, 28.89%). Compared to children without pulmonary pleural lesion, children with pulmonary pleural lesion had higher incidence of leukopenia, lower C₃ or antibody dsDNA (+) (all P<0.05). There was no difference in abnormality of erythrocyte sedimentation rate (ESR), CRP, IgG,IgA,IgM, thrombocytopenia, antibody ANA(+), anti-SSA(+), anti-SSB(+) or anti-Sm(+) between children with or without pulmonary pleural lesion (P>0.05).</p><p><b>CONCLUSION</b>High incidence of pulmonary pleura lesions are present in children with SLE, however, clinical manifestations are lack of specificity or even no respiratory manifestation. Chest X-ray or HRCT scan are necessary in all cases with SLE. Children with leukopenia, lower C₃ or antibody dsDNA (+) are more likely to have pulmonary pleural lesion.</p>

Comparison of clinical characteristics between patients with non-allergic and allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze and compare the differences of clinical characteristics and comorbidities between patients with non-allergic rhinitis (NAR) and allergic rhinitis (AR).</p><p><b>METHODS</b>A total of 556 out-patients were enrolled from January 2010 to June 2011. The chief complaints of the patients included at least two of the following nasal symptoms: nasal congestion, rhinorrhea, sneezing, and nasal itching. Based on the results of the disease history, physical examination and allergen skin prick test, the patients were classified into NAR group (n = 206) and AR group (n = 350). Detailed information including general data, nasal symptoms and signs, accompanied symptoms and comorbidities were obtained by questionnaires. A scoring was adopted to estimate the severity of disease. SPSS 13.0 software was applied for statistical analysis.</p><p><b>RESULTS</b>The mean age of NAR patients (31.8 ± 16.7) was older than that of AR patients (26.3 ± 14.8), and the difference was significant (t = 4.01, P = 0.0001). While there was no significant difference on gender distribution between two groups (χ² = 0.12, P = 0.73). The percentage of nasal congestion was not significantly different between NAR and AR patients (89.8% and 92.0%, respectively; χ² = 0.26, P = 0.611). However, the symptoms of rhinorrhea, sneezing, nasal itching, eyes itching, lachrymation, wheeze and cough were more popular in AR patients than those in NAR patients (all P < 0.05). Moreover, above symptoms (except cough) were more serious in AR patients, and the symptom scores were significantly higher than those in NAR patients (all P < 0.05). Most of patients with NAR (67.0%) and AR (62.9%) were moderate-severe persistent (χ² = 1.25, P = 0.264). Accompanied asthma were more common in patients with AR (12.6%) compared with NAR (2.4%), while hypertension were more common in patients with NAR (7.3%) compared with AR (1.7%), and the differences were significant (both P < 0.05).</p><p><b>CONCLUSION</b>NAR and AR are two different disease entities, which have different clinical characteristics, as well as different comorbidities. Further clinical study should be done on the rhinitis phenotypes.</p>

Correlation of serum eosinophil cationic protein with the severity of allergic rhinitis in childhood / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the relationships between the severity of childhood allergic rhinitis (AR) and the peripheral blood eosinophil count, serum eosinophil cationic protein (ECP), total IgE (tIgE), and allergen-specific IgE (sIgE) levels.</p><p><b>METHODS</b>A total of 138 children with AR aged 3 to 17 (9.96 ± 3.78, x() ± s) years old were enrolled in the study. All children had persistent AR sensitized to house dust mites with a clinical history of 3 months to 12 (4.21 ± 2.72) years. The disease severity was evaluated using 10 cm-visual analogue scale (VAS), and the serum levels of ECP, tIgE and sIgE were determined using an ImmunoCAP system. Statistical analysis was conducted with SPSS11.0 software.</p><p><b>RESULTS</b>Among 138 children with AR, the VAS scores for global severity of rhinitis and nasal obstruction symptom were 5.32 ± 2.16 and 4.78 ± 2.45, respectively. Blood eosinophil count was 0.39 [0.24; 0.63] (M[P(25); P(75)]) ×10(9)/ml. Serum levels of ECP and total IgE were 10.60 [3.26; 30.80] µg/L and (2.50 ± 0.53) log kU/L, respectively. Serum levels of allergen-sIgE against Dermatophagoides pteronyssinus and Dermatophagoides farinae were 58.20[24.75; > 100] kUA/L and 54.95 [24.55; > 100] kUA/L, respectively. The VAS scores of nasal obstruction symptom, but not global severity of rhinitis, were positively related to the duration of AR (r = 0.215, P = 0.011) and the levels of serum ECP (r = 0.196, P = 0.022) in bivariate correlation analysis. There was also a significant correlation between the serum ECP level and the blood eosinophil count (r = 0.295, P = 0.000). No relationships of blood eosinophil count, and serum tIgE and sIgE levels with global severity of rhinitis as well as nasal obstruction symptom were found (all P > 0.05).</p><p><b>CONCLUSIONS</b>These results suggested that the severity of nasal obstruction was positively correlated with the duration of rhinitis and the levels of serum ECP in childhood persistent AR due to house dust mites, indicating the disease severity might be related to chronic inflammatory process.</p>

Association of TGFB1 gene polymorphism -509C/T with disease severity in childhood allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the association between the promoter polymorphism -509C/T of the transforming growth factor-β1 gene (TGFB1) and the disease severity of allergic rhinitis (AR) in childhood.</p><p><b>METHODS</b>A total of 96 Chinese patients with persistent AR aged 3 - 17 (9.4 ± 3.8) years old were enrolled in the study. Among these patients 53.1% were mild cases (n = 51) and 46.9% were moderate-to-severe cases (n = 45). Genotyping was performed on peripheral blood genomic DNA by using PCR-RFLP. Serum levels of TGF-β1 was measured by ELISA, and serum total IgE, specific IgE and eosinophil cationic protein (ECP) levels were determined using an ImmunoCAP100E system. Statistical analysis was conducted with SPSS11.0 software.</p><p><b>RESULTS</b>Significant differences were found in genotype frequencies for the TGFB1-509C/T polymorphism between mild and moderate-to-severe AR patients (χ(2) = 8.361, P = 0.015). Children with persistent AR bearing the TT genotype of the -509C/T polymorphism had significantly increased risk for moderate-to-severe AR (Fisher's exact test, P = 0.007) compared to children with the CC/CT genotypes. There was no significant association between the -509C/T polymorphism and serum TGF-β1 levels (F = 0.389, P = 0.679); however, serum total IgE (F = 4.210, P = 0.018) and ECP (H = 6.297, P = 0.043) levels were found to be significantly associated with the polymorphism.</p><p><b>CONCLUSION</b>The results suggest that the TGFB1 gene polymorphism -509C/T may play a potential role in the severity of persistent AR in childhood.</p>

Comparison of risk factors between patients with non-allergic rhinitis and allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate and describe the differences in age, sex, seasonality distribution, and related environmental factors between patients with non-allergic rhinitis (NAR) and allergic rhinitis (AR).</p><p><b>METHODS</b>One hundred and eleven patients with NAR and 112 patients with AR were enrolled in this study. All patients were first diagnosed in outpatient department between January and August 2010. Questionnaires were distributed to all participants to record the general information, medical history, and the factors relevant to symptom onset. Statistical analysis was performed using a SPSS13.0 software.</p><p><b>RESULTS</b>The proportion of patients with NAR increased with age, compared to patients with AR. The peak age was 21 - 30 years old in patients with NAR, whereas 11 - 20 years old in patients with AR. In adults more than 18 years old, the average age (years, x(-) ± s) of patients with NAR (38.6 ± 14.5) was significantly higher than those with AR (32.8 ± 13.0; t = 2.58, P = 0.024). NAR was more likely to be males before 30 years old, while after 30 years old, it likely to be female predominance. The same case occurred in AR subjects but in their 20 years old. NAR was symptomatically worse in winter (χ(2) = 27.57, P = 0.000), whereas AR worse in spring (χ(2) = 13.75, P = 0.003). The cases of NAR were significantly more than those of AR during the winter season (χ(2) = 12.34, P = 0.000). Among the disease-related environmental factors, living or working place near the traffic artery had 1.94-fold increased risk for development of NAR compared with AR; however, living or working in ground floor or sunshine time less than 2 h per day had 1.77- or 1.91-fold increased risk for development of NAR compared with NAR. Subjects with personal or family history of allergic disease had 2.14 to 4.06-fold increased risk for development of AR compared with NAR. The self-reported predisposing factors in NAR patients were mainly including temperature shift (56.3%), common cold (52.8%), climate change (32.4%), and strong odors (31.1%). However, there were no significant differences in these nonspecific triggers between NAR and AR (all P > 0.05).</p><p><b>CONCLUSION</b>There are significant differences in the distribution of age, sex and seasonality, personal and family history of allergic disease, and some environmental factors relevant to the onset of symptom between patients with NAR and AR.</p>

Anti-nasopharyngeal carcinoma effect in vivo and in vitro of cytotoxicity T lymphocyte induced by Ad5-latent membrane protein 2A / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the biological characteristics of cytotoxicity T lymphocyte (CTL) induced by dendritic cell (DC) transfected with the Epstein-Barr virus latent membrane protein 2A (EBV-LMP2A) recombinant adenovirus. To establish nasopharyngeal carcinoma (NPC) animal models expressing LMP2A and investigate the anti-tumor effect of LMP2A specific CTL in vivo.</p><p><b>METHODS</b>The mononuclear cells were isolated from human peripheral blood mononuclear cells (PBMC) and cultured with the cytokines [granulocyto-monocyte colony stimulating factor (GM-CSF), interleukin-4 (IL-4) and tumor necrosis factor-alpha TNF-alpha]. The expression of surface markers on mature DC was detected by fluorescence activated cell sorter FACS. Mature DC were transfected with LMP2A recombinant adenovirus. Under the help of interleukin-2 (IL-2), LMP2A specific CTL were induced by coculturing LMP2A-transfected DC with autologous PBMC. The population of CTL was detected by FACS. NPC animal models were constructed by implanting CNE cells expressing LMP2A subcutaneously into BALB/c nude mice. After intra-tumoral injection of LMP2A specific CTL, the size of tumor was measured. The tumors were removed after 30 d and subjected to histological examination.</p><p><b>RESULTS</b>Mature DC displaying typical characteristics of morphology and phenotype were obtained from monocytes cultured in the medium containing GM-CSF, IL-4 and TNF-alpha. The LMP2A specific CTL induced by transfected DC were composed of mainly CD4+ and CD8+ T cells. The NPC animal models were constructed three weeks after implanting CNE cells. The study in vivo indicated that the tumors treated with LMP2A specific CTL grew slowly compared with control. Tumor volume of treated groups was significantly smaller than that of controls. The histological sections showed local necrosis and infiltration of lymphocyte in tumor tissue.</p><p><b>CONCLUSIONS</b>Typically mature DC could be generated in vitro by culturing monocytes with the cytokines. LMP2A-specific CTL could be induced by LMP2A transfected DC in vitro. NPC mice models could be constructed by implanting CNE cells. LMP2A specific CTL could inhibit the growth of implanted tumor and produce an anti-tumor effect in vivo.</p>

Anti-inflammation and anti-oxidation effects of recombinant human superoxide dismutase on acute lung injury induced by meconium aspiration in infant rats / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the anti-inflammation and anti-oxidation effects of recombinant human CuZn superoxide dismutase(rhSOD) on acute lung injury (ALI) induced by meconium aspiration in rats.</p><p><b>METHODS</b>1 ml/kg of 20% human newborn meconium suspension was intratracheally (IT) administrated to induce the model of ALI in 32 male Sprage-Dawley rats, and the animals were then randomized to 4 groups: 3 treatment groups with IT administration of 5, 10 and 20 mg/kg rhSOD dissolved in 1 ml/kg saline and the control group with IT administration of 1 ml/kg saline. The animals were killed after 24 h of treatments. The measurements included lung tissue wet/dry ratio, broncho-alveolar lavage fluid (BALF) protein, BALF protein/plasma protein (pulmonary permeability index, PPI),lung myeloperoxidase (MPO) and superoxide dismutase (SOD) activity, nitric oxide (NO) and 8-isoprostane levels. Lung injury score was also evaluated.</p><p><b>RESULTS</b>Compared with the control group, pulmonary MPO activity, NO and 8-isoprostane levels were significantly decreased and SOD activity was markedly increased in all rhSOD treatment groups (P<0.05 or 0.01). Compared with the rhSOD 5 mg/kg group, pulmonary 8-isoprostane level was further low in the rhSOD 20 mg/kg group(P=0.01). Lung injury score was decreased in rhSOD 20 mg/kg group (P<0.05). But there were no statistically differences in lung wet/dry, BALF protein and PPI among all groups.</p><p><b>CONCLUSION</b>The results suggest that a single IT dose of 5,10 or 20 mg/kg rhSOD can prevent lung damages in rats with ALI following meconium aspiration.</p>

Protective effects and mechanisms of recombinant human superoxide dismutase in acute lung injury of rats following meconium aspiration / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate the protective effects of recombinant human superoxide dismutase (rhSOD) in acute lung injury (ALI) following meconium aspiration.</p><p><b>METHODS</b>Thirty-two healthy male Sprage-Dawley rats were divided into two groups, 8 were used as control (saline group) by infusing 1 ml/kg saline through endotracheal tube; the other 24 rats were used to establish model of ALI by infusing 1 ml/kg of 20% human newborn meconium suspension through endotracheal tube, and then were randomized to 3 groups (8 each): meconium group with no administration of saline or rhSOD; meconium + saline group by infusing 1 ml/kg saline through endotracheal tube; meconium + rhSOD group by infusing 20 mg/kg rhSOD dissolved in 1 ml/kg saline through endotracheal tube. The rats were killed 24 h after treatment. The measurements included bronchoalveolar lavage fluid (BALF) cell counts, protein, BALF protein/plasma protein (pulmonary permibility index, PPI), lactic dehydrogenase (LDH), pulmonary myeloperoxidase (MPO) and superoxide dismutase (SOD) activity, malonyldialdehyde (MDA) and nitric oxide (NO) level. Lung injury score was also evaluated.</p><p><b>RESULTS</b>Compared with the saline group, the rats in the meconium group had significantly increased BALF cell counts (4.04 +/- 1.01 vs. 0.53 +/- 0.19), protein (2.54 +/- 0.74 vs. 0.67 +/- 0.26), PPI (0.50 +/- 0.18 vs. 0.12 +/- 0.05), LDH (263.50 +/- 97.84 vs. 17.38 +/- 3.58), pulmonary MPO (1.49 +/- 0.22 vs. 0.62 +/- 0.16), MDA (3.30 +/- 0.85 vs. 1.40 +/- 0.35), NO (12.77 +/- 5.00 vs. 4.89 +/- 1.32) and lung injury score (9.88 +/- 2.10 vs. 2.25 +/- 1.04), P < 0.01 for all, whereas pulmonary SOD activity had no statistically significant differences (103.28 +/- 24.53 vs. 94.49 +/- 12.93, P > 0.05). There were no statistically significant differences between meconium + saline group and meconium group (all P > 0.05). Compared with the meconium + saline group, meconium + rhSOD group had decreased BALF cell counts (3.13 +/- 0.77 vs. 4.68 +/- 1.40, P < 0.01), LDH (162.63 +/- 76.90 vs. 273.75 +/- 111.83, P < 0.05), pulmonary MPO activity (1.23 +/- 0.28 vs. 1.54 +/- 0.24, P < 0.05), MDA (2.46 +/- 0.42 vs. 3.50 +/- 0.82, P < 0.01), NO level (9.17 +/- 2.34 vs. 13.04 +/- 4.38, P < 0.05), lung injury score (8.63 +/- 1.30 vs. 10.00 +/- 1.07, P < 0.05) and increased pulmonary SOD activity (134.45 +/- 23.30 vs. 106.79 +/- 17.77, P < 0.05), but there were no statistically significant differences in BALF protein and PPI between these two groups.</p><p><b>CONCLUSION</b>Inflammation and lipid peroxidation might play important roles in the pathogenesis of ALI with meconium aspiration, a single early administration of 20 mg/kg rhSOD intratracheally can reduce lung damage in rats following meconium aspiration.</p>

Study on the bacterial identification using 16S-23S rRNA gene spacer regions / 浙江大学学报·医学版

OBJECTIVE: To examine the use of PCR utilizing 16S-23S rRNA gene spacer regions in the identification of bacteria. METHODS Primers used in PCR were designed by using the target sequences from the genes encoding 16S-23S rRNA spacer regions. PCR was used for the detection of different standard and clinical bacterial strains. RESULTS Characteristic DNA maps were present after using the PCR to identify 27 standard strains from 27 species. The maps could be directly used for classification of the tested bacterial strains or further differentiated by RFLP. The sensitivity of the PCR may be as high as 2.5 CFU/ml. No non-specific amplification products were observed when using DNA from human PBMC funguses or viruses as templates. Thirty-two strains of bacteria isolated from clinical strains showed DNA maps similar to the DNA maps amplified from standard strains. CONCLUSION The PCR detection of bacteria using 16S-23S rRNA gene spacer regions is sensitive, rapid, specific and accurate for identification of bacteria and provides a new rapid method for determining the clinical diagnosis and the etiology of sepsis.