The Janus kinase (JAK) /signal transducer and activator of transcription (STAT) signaling pathway plays an important role in the occurrence of dermatomyositis. JAK inhibitors can block signal transduction dependent on JAK/STAT pathway-related factors, and inhibit immune cell activation and T cell-mediated inflammatory responses. So far, the US Food and Drug Administration (FDA) has only approved rheumatic arthritis and myelofibrosis as the indications of JAK inhibitors, but there have been many reports on JAK inhibitors for the treatment of refractory dermatomyositis. This review summarizes the role of JAK/STAT pathway in the pathogenesis of dermatomyositis, the mechanism of action and clinical application of JAK inhibitors in the treatment of dermatomyositis.

Objective To understand the risk factors of allergic rhinitis in adults. Methods Using 1:1 paired matching case-control study design, 100 pairs of adults allergic rhinitis patients and the relevant controls from the E.N.T. department of Renmin Hospital of Peking University were recruited. Cases and controls were interviewed face to face using a designed health questionnaire in which the general social demographic characters, disease history, smoking history, occupation, indoor environmental situation and family genetic history were included. The questionnaires were analyzed by signal and multiple regression model of SPSS software. Results Allergic rhinitis was associated with the pollen allergic history (OR=2.04,95%CI: 1.31-3.20), occupational exposure to dust was a risk factor of allergic rhinitis (OR=1.46, 95%CI:0.83-2.57), the mother allergic rhinitis history could increase the risk of their off-springs suffering from allergic rhinitis(OR=2.05, 95%CI:1.03-4.07) and keeping ventilation could significantly decrease the risk suffering from allergic rhinitis(OR=0.70, 95%CI:0.34-1.18). Conclusion The occupational dust exposure, pollen allergy and mother allergic rhinitis history are related to allergic rhinitis in adults. Keeping ventilation may be a protective factor of allergic rhinitis in adults.

Objective To investigate the application of transthoracic echocardiography (TTE) and 320-row CT in diagnosis of complex congenital heart disease(CCHD).Methods A retrospective analysis was performed in 68 patients with CCHD,which contained the echocardiographic apprarance,320-row CT and surgical outcoming.All of malformations were divided into three groups:intracardiac group,heart-large vascular connecting group and extracardiac group.Results One hundred and eighty-four malformations were comfirmed by surgery in the 68 cases.The misdiagnosis and missed diagnosis rate of CT and TTE:for the intracardiac anomalies were 12％ (11/93),1％ (1/93) respectively (P ＜ 0.05),for the heart-large vascular connecting malformation were 4％ (2/49),6％ (3/49) respectively (P ＞ 0.05),and for the extracardiac anomalies were 2％(1/42),19％(8/42) respectively (P ＜0.05),for the total anomalies were 8％(14/184),7％ (12/184) respectively (P ＞0.05).While it was 1％ (2/184) in diagnosis of total anomalies by both CT and TTE.Conclusions Both 320-row CT and TTE have their own advantages and shortcomings in the diagnosis of CCHD.Joint application of two methods could reduce the rate of misdiagnosis and missed diagnosis of CCHD.

Objective To investigate the application of prenatal ultrasonograpy in diagnosis of fetal heart disease during the medium-term and terminal pregnancy,and to avoid misdiagnosis.Methods The prenatal ultrasonographic screening was conducted in 7020 pregnant women with medium-term and terminal pregnancy.All confirmed and suspicious cases of fetal heart disease were observed by echocardiography once 4 weeks until postnatal sixth month to 1 year while normal cases was traced at the intervals of 8 weeks.All the cases were confirmed by autopsy or surgery while part of them were confirmed by postnatal angiocardiography before surgery.The reasons of misdiagnosis were analyzed.Results In fifty-three cases of fetal cardiovascular abnormality,43 cases were found,2 cases were misdiagnosis while 8 cases were missed diagnosis.2 cases of misdiagnosis included 1 case of pulmonary valve stenosis and 1 case of tetralogy of Fallot.8 cases of miss diagnosis included 2 cases of inferior vena cava in ectopic drainage and 6 cases of ventricular septal defect (defect diameter ＜ 5 mm).The accuracy rate of diagnosis of fetal heart disease was 81.1 ％ by echocardiography.Conclusions Using high frequency probe,image zoom,enhancing the detection of vein-atrium connection and the structure of right ventricular outflow with pulmonary artery are important factors to avoid missed diagnosis and incomplete diagnosis.

OBJECTIVE:To strengthen the management of dismounting drugs in hospital and improve pharmacist working effi-ciency by designing and mading an oral dispending desk. METHODS:In order to solve the small number of placing dismounting drugs induced by small capacity of the desk and disorder placement of placing medicines in inpatient pharmacy,our pharmacists de-signed a new kind of oral dispensing desk that can solve the above problems,produced it and put it in the daily clinical work. The application effects were evaluated by comparing the number of placing drugs and deployment time of medical orders before and af-ter applying it. RESULTS:The designed oral dispensing desk included square slots in the bench,round slots on the side,operating table,multi-panel drawer and ordinary drawer,in which,the first two parts could be used for placing drugs with different shapes and different sizes,multi-panel drawer could place oral liquid,granules,etc. The total number of placing drugs was increased from 237 to 290,and the average deployment time of each medical order was shortened from(4.55±0.38)s to(3.52±0.16)s. CON-CLUSIONS:Application of new dispensing desk has not only solved the limited capacity of the desk,disorderly placing dismount-ing drugs,being difficult to locate and manage and other problems,but also improved the deployment speed of pharmacists and promoted standardized management of dismounting drugs.

OBJECTIVE: To evaluate the efficacy and safety of mite allergen specific immunotherapy (SIT) in treating children with allergic asthma. METHOD: A total of 136 patients with mite allergy were recruited into the study. They were randomly divided into two groups: SIT group (n = 66) and ST (symptomatic therapy) group (n = 70). They were investigated of SIT with standardized allergen vaccine or no SIT only symptomatic therapy respectively. Therapeutic evaluation index includes: asthma symptoms score, drug score, skin prick test, pulmonary function, serum specificity IgE (sIgE) and the new sensitization was also assessed. Local and systemic adverse reactions were used to evaluate the clinical safety. RESULT: Clinical symptom scores, drug scores, Lung function, and skin test result all improved significantly after the treatment with SIT compared to ST group (P < 0.01). SIT groups do not have new sensitization and no fatal systemic reactions occurred. CONCLUSION The standardized dust mite allergen specific immunotherapy is efficacious and safe to Children with allergic asthma . SIT can reduce house dust mites skin sensitivity and prevent new allergen appeared.
Adolescent ; Allergens ; therapeutic use ; Animals ; Antigens, Dermatophagoides ; therapeutic use ; Asthma ; immunology ; therapy ; Child ; Dust ; Female ; Humans ; Hypersensitivity ; immunology ; therapy ; Immunotherapy ; methods ; Male ; Pyroglyphidae ; immunology ; Safety ; Sensitivity and Specificity ; Skin Tests ; Vaccines ; therapeutic use

OBJECTIVE: To evaluate the effect of allergen specific immunotherapy (SIT) in patients with allergic rhinitis and asthma. METHOD A total of 68 patients with allergic rhinitis and asthma sensitized to dust mite were recruited into the study. They were randomly divided into two groups: SIT group n = 34 and symptomatic therapy (ST) group: n = 34. Patients in ST group received medication to treat, the symptoms, patients in SIT group received medication and 3 years of standardized allergen vaccine therapy. Evaluation index of therapy includes: rhinitis symptoms score, asthma symptoms score, drug score, skin prick test, serum specificity IgE (sIgE) , peripheral eosinophil (Eos) counting, lung function. The new sensitinogen rate was also assessed. RESULT: Clinical symptom scores, drug scores, lung function, blood eosinophil numbers and skin test result were all improved significantly after 3-year treatment in SIT group compared to those in ST group (P < 0.01). Although the level of serum slgE was decreased,there exited no statistic diferences between two groups. Only 8.8% patients have the new sensitization in SIT group, and 52.9% in ST group. There were no serious adverse reactions in treatment process. CONCLUSION SIT for patients with AR and asthma can obtain excellent clinical efficacy.
Animals ; Asthma ; drug therapy ; Desensitization, Immunologic ; Eosinophils ; Humans ; Immunoglobulin E ; blood ; Leukocyte Count ; Pyroglyphidae ; Rhinitis, Allergic ; drug therapy ; Sensitivity and Specificity ; Skin Tests

Objective To investigate the different expressions of pathological tissue and serum microRNAs (miRNAs)in Hirschsprung disease(HSCR). Methods Pathological colon tissues and serum samples were obtained from 52 confirmed HSCR cases respectively by surgery and pathology and from 52 matched controls,respectively. An initial screening of the tissues and serum microRNA expression were performed through TaqMan Low Density Array. The candidate tissue and serum miRNAs were validated by quantitative real - time - PCR in the 20 paired array samples and extra 32 paired samples after the integration of the screening result. The bioinformatical software online including miR-base,Target Scan,PicTar and MiRanda were used to predict the target mRNA of the consistent microRNAs in the tis-sues and the serum. Results Compared with the controls,47 microRNAs were differently expressed in HSCR tissues, including 17 up - regulated miRNAs and 30 down - regulated miRNAs;32 upregulated miRNAs were also detected to be differently expressed in the HSCR serum. Among these microRNAs,miR - 218 - 1 and miR - 885 - 5p were identi-fied to have a consistent significant different expression in both tissues and the serum,which were validated as high -expressed in microarray samples and expanded 32 paired samples(miR - 218 - 1:tissue array 0. 017 58 ± 0. 002 29 vs 0. 003 37 ± 0. 000 50,P ﹤ 0. 001;tissue expanded expression 0. 013 53 ± 0. 001 74 vs 0. 004 43 ± 0. 000 60,P ﹤0. 001. miR - 885 - 5p:tissue array 0. 000 30 ± 0. 000 11 vs 0. 000 04 ± 0. 0000 08,P = 0. 027 6;tissue expanded ex-pression 0. 004 59 ± 0. 000 16 vs 0. 000 04 ± 0. 000 01,P = 0. 014 5. miR - 218 - 1:serum array 0. 769 60 ± 0. 285 50 vs 0. 045 14 ± 0. 015 07,P = 0. 015 5;serum expanded expression 1. 151 00 ± 0. 430 00 vs 0. 023 07 ± 0. 003 81,P =0. 008 7. miR -885 -5p:serum array 1. 595 00 ±0. 441 70 vs 0. 169 40 ±0. 034 46,P =0. 001 2;serum expanded expres-sion 1. 689 00 ±0. 453 00 vs 0. 146 10 ± 0. 031 24,P = 0. 001 2). Specifically,the target genes of these 2 microRNAs were RET,PLAG1 and NeuroD1,which had been reported to be directly related to HSCR. Conclusions Significantly dif-ferential expressed miRNAs exist in the pathological tissue and the serum of HSCR. MiR - 218 - 1 and miR - 885 - 5p, which showing consistent differential expression,may be involved in the pathogenesis of HSCR.

Objective To assess the application of Chinese children's intelligence equation (CCIE) and Bayley Scales of infant and toddler development-Ⅲ (BSID-Ⅲ) in screening of postoperative cognitive dysfunction (POCD) in children after general anesthesia.Methods The study group (Group A),including 50 ASA-Ⅰ participants of 1-3 years old who would undergo hernia repair laparoscopic surgery,was assessed on one day (1 d) before and three days (3d) after the surgery respectively by both of CCIE and BSID-Ⅲ according to their ages of month.The control group (Group C),including 50 healthy participants with the matched age,was assessed in the same period by the same method.Both of Group A and C were assessed by the Z score method to diagnose POCD and both scales were used to analyze the results of POCD screening and their agreement.Results (1) Compared with preoperative 1 d,the CCIE score of Group A on 3d after surgery was relatively decreased (21.22±4.96 vs 18.65±4.74,P＜0.05) and the POCD rate was 12.0％.While in Group C,the CCIE score and the POCD rate had no statistical significance (20.83±4.97 vs 21.22±5.21,P＞0.05).(2) Compared with preoperative 1d,the scores of cognition,language,motion,social-emotion and adaptive behaviors in BSID-Ⅲ of Group A decreased (100.00±4.58 vs 96.44± 4.20,103.22±4.99 vs 96.24± 5.75,102.06±4.01 vs 95.28±4.27,101.22±7.38 vs 91.06±7.10,98.52±9.11 vs 90.5±8.47,P＜0.05) and the POCD incidence was 20.0％.While in group C,the BSID-Ⅲ score and the POCD rate had no statistical significance (104.61±5.48 vs 103.79±5.38,107.68±5.60 vs 107.11 ±6.05,108.29±5.91 vs 108.29±4.21,101.11±7.61 vs 101.86±6.99,99.00±7.99 vs 100.82±7.36,P＞0.05).(3)Reasonable agreement of the CCIE and BSID-Ⅲ was observed (Kappa value was 0.70;P＜ 0.05).Conclusion There is considerable agreement between BSID-Ⅲ and CCIE.While BSID-Ⅲ is relatively more sensitive to the POCD and more efficient in the diagnosis of POCD than the CCIE.Thus,BSID-Ⅲ is more likely to provide better evaluation of the postoperative cognitive functions of children within 1-3 years old and should be recommended to the health professionals in China.

Objective To investigate the influence of electroacupuncture(EA) in different points combined with spinal anesthesia on acute stress response and mechanisms related with expression of spinal c-fos protein. Methods Fifty adult male Sprague-Dawley rats were randomly divided into 5 groups:groupⅠwere normal rats receiving only 50μL saline intrathecal IT injection;groupⅡwere docked rats receiving IT with 50 μL saline;groupⅢ were docked rats receiving IT injection of 50 μL, 2.5 μg fentanyl; group Ⅳwere docked rats receiving IT injection of fentanyl 50μL and EA at′zu-san-li′;groupⅤwere docked rats receiving EA at′er xue′and IT fentanyl. Serum corticosterone (CORT) and adrenocorticotropic hormone (ACTH) levels were measured by ELISA. Determined the c-fos protein expression levels of L4-6 spinal by western blotting. Result GroupⅡACTH, CORT levels and c-fos expression was significantly higher than those in groupⅠ(P<0.01). Compared with groupⅡ, groupⅢ,ⅣandⅤhad higher ACTH and CORT levels (P<0.05). However, c-fos expression in the spinal cord between groupⅡandⅢshowed no difference (P>0.05). Between groupⅢandⅣ, no differences in serum hormone levels (P > 0.05) were detected. In group Ⅴ the c-fos expression was lower than that of the Ⅳ group (P < 0.01). Conclusion Body acupuncture and auricular electrical stimulation combined with intrathecal anesthesia were effective to reduce pain in rats with acute stress reactions. Under intrathecal anesthesia, auricular stimulation played a better role of non-nerve block region, and the mechanism may be due to the release of neurotransmitters induced c-fos protein in spinal cord.