It has always been controversial whether a single allergen performs better than multiple allergens in polysensitized patients during the allergen-specific immunotherapy.This study aimed to examine the clinical efficacy of single-allergen sublingual immunotherapy (SLIT) versus multi-allergen subcutaneous immunotherapy (SCIT) and to discover the change of the biomarker IL-4 after 1-year immunotherapy in polysensitized children aged 6-13 years with allergic rhinitis (AR) induced by house dust mites (HDMs).The AR polysensitized children (n=78) were randomly divided into two groups:SLIT group and SCIT group.Patients in the SLIT group sublingually received a single HDM extract and those in the SCIT group were subcutaneously given multiple-allergen extracts (HDM in combination with other clinically relevant allergen extracts).Before and 1 year after the allergen-specific immunotherapy (ASIT),the total nasal symptom scores (TNSS),total medication scores (TMS) and IL-4 levels in peripheral blood mononuclear cells (PBMCs) were compared respectively between the two groups.The results showed that the TNSS were greatly improved,and the TMS and IL-4 levels were significantly decreased after 1-year ASIT in both groups (SLIT group:P＜0.001;SCIT group:P＜0.001).There were no significant differences in any outcome measures between the two groups (for TNSS:P＞0.05;for TMS:P＞0.05;for IL-4 levels:P＞0.05).It was concluded that the clinical efficacy of single-allergen SLIT is comparable with that of multi-allergen SCIT in 6-13-year-old children with HDM-induced AR.

Objective To investigate the potential role of respiratory syncytial virus (RSV) in wheezing episode in children, and to assess the association of the thromboxane A2 receptor gene (TBXA2R) T924C polymorphism with wheezing after RSV infection. Methods From may to december in 2008, one hundred and twenty-five asthmatic children who were suffering from acute episode were recruited as cases and 49 healthy children as controls in our Polymerase chain reactions-Restriction fragment length polymorphism (PCR-RELP) techniques were used to detect the TBXA2R SNP. RSV IgM and IgG were measured by ELISA. Results RSV specific antibody was positive in 57 asthmatic patients (45.6% ,57/125) and 8 controls (16.33% ,8/49) ,with significant difference between the two groups ( χ2 = 12. 890, P = 0. age asthmatic group and 76. 92% (30/39) in the <3 years of age asthmatic group, with significant difference between the two groups (χ2 = 22. 420, P = 0. 000 ). The genotypes distribution in the asthmatic patients was significantly different from that in the controls(χ2 = 5. 346, P = 0. 021). The frequency of TC and CC genotypes in the cases was significantly higher than that in the control group. The allele frequencies of T and C allele were similar in the two groups ( χ2 =2.660, P=0.103). Conclusions RSV infection was one of the factors that associated with asthma acute episode, especially in children younger than 3 years. The TC,CC genotypes increase the chance of wheezing in children infected by RSV.

ObjectiveTo observe the effects of acupuncture combined with massage on shoulder subluxation and motor function recovery of the upper extremities in patients with hemiplegia after stroke.Methods60 hemiplegic patients were randomly divided into two groups for treatment with acupuncture cooperates with massage or usual rehabilition, respectively. The recovery of the patient's shoulder subluxation and movement function of upper extremities were evaluated 2 months after treatment. ResultsThe shoulder subluxation and movement function of the upper extremities were improved after treatment with both therapies (P<0.01), and acupuncture cooperates with massage showed better effect (P<0.01). ConclusionAcupuncture cooperates with massage can facilitate the recovery of shoulder subluxation and motor function of the upper extremities after hemiplegia.

Objective To investigate the surgical efficacy for the treatment of ruptured anterior communicating artery aneurysms with different dome projections in acute phase via supraorbital lateral approach.Methods From January 2014 to March 2017,the clinical data of 79 patients with acute ruptured anterior communicating artery aneurysm with different dome projections in acute phase treated via supraorbital lateral approach in the First Affiliated Hospital of Soochow University were retrospectively analyzed.The operative efficacy was analyzed.The Glasgow outcome scale (GOS) score was used to evaluate the prognosis at 3-36 months after procedure.Results In the 79 patients,34 were superior dome projections,37 was inferior dome projections,and 8 were complicated dome projections.All the anterior communicating artery aneurysms were successfully clipped.The patients were followed up for 3-36 months after procedure.GOS showed good prognosis in 70 cases (88.6％),of which 26 were superior dome projections,36 were inferior dome projections,and 8 were complicated dome projections;9 suffered mild disability (11.4％),of which 8 were superior dome projections and 1 was inferior dome projection.There were no severe disability,persistent vegetative state,and death.The prognosis in patients with inferior dome projection was better than that of superior dome projection (97.3％ [36/37] vs.76.5％ [26/34]).The difference was statistically significant (χ2=5.19,P<0.05).Conclusions The lateral supraorbital approach is an effective option for treating ruptured ACoAA with different dome projections in acute phase.The prognosis in patients with inferior dome projection is better than that of superior dome projection.

OBJECTIVE:To observe clinical efficacy and safety of tiotropium bromide combined with budesonide formoterol in the treatment of severe bronchial asthma in adults. METHODS:A total of 110 adult patients with severe bronchial asthma were selected from our hospital during Mar. 2013-Mar. 2016 were divided into control group and observation group according to random number table,with 55 cases in each group. Control group was given Budesonide formoterol powder for inhalation,2 inhalations each time,bid;observation group was additionally given Tiotropium bromide powder for inhalation 18 μg,qd,on the basis of con-trol group. Both groups were treated for 6 months. Clinical efficacies as well as ACT scores,respiration function indexes and the times of acute attack of asthma before and after treatment,the occurrence of ADR were compared between 2 groups. RESULTS:The efficiency rate and total response rate of observation group were 54.55% and 96.36%,which were significantly higher than 32.73%,78.18% in control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in ACT scores,respiration function indexes or the times of acute attack of asthma between 2 groups(P>0.05). After treatment,ACT scores of 2 groups were significantly higher than before treatment;FEV1,FEV1/FVC and PEF were significantly greater than be-fore treatment,PEFR was significantly lower than before treatment;and the indexes in observation group was significantly better than control group,with statistical significance(P<0.05). 1,3,6 months after treatment,the times of acute attack of asthma in 2 groups were significantly less than before treatment,and that in observation group was significantly less than control group,with statistical significance(P<0.05). The incidence of ADR in observation group was 20.00%,and there was no statistical signifi-cance compared to 14.55% of control group(P>0.05). CONCLUSIONS:Tiotropium bromide combined with budesonide formoter-ol in the treatment of severe bronchial asthma in adults can effectively relieve the severity of disease,improve respiration function, reduce the times of acute attack of asthma,and have good therapeutic efficacy and safety.

In view of risk characteristics of surgical site infection,the risk factors of the infection were graded and classified while the risk indicators system and risk assessment matrix for surgical site infection were built,based on literature analysis,integrated use of documents analysis,Delphi method and risk quantification matrix.The study indicated that surgical skills of the surgeon and surgical time length are the most important risk factors,followed by insufficient maintenance of the operating room environment and poor baseline assessment of the patient.Risk control of surgical site infection needs to focus on these key factors,optimize utilization of resources and improve the prevention and control ability of surgical site infection.

Objective To analyze the efficacy and safety of pramipexole in treating restless legs syndrome (RLS) to different races.Methods A search for randomized,double-blind,and placebocontrolled clinical trials of pramipexole in treating RLS using Pubmed was carried out.A meta-analysis of included clinical trials was performed with Revman 5.2.The efficacy was calculated based on the change of the weighted mean difference (WMD) with International Restless Legs Syndrome Study Group rating scale (IRLS) and the relative risk (RR) of response with Clinical Global Impression-Improvement (CGI-I) scale.Safety was assessed with RR of the adverse event (AE).Subgroup analysis was conducted in the white race subgroup and the yellow race subgroup,separately.Results A total of 6 clinical trials were included in this meta-analysis.The records of patients were pooled.Overall,WMD of the change in IRLS score was-4.72 (Z =6.57,P ＜ 0.01),which was-4.33 in white race subgroup (Z =3.90,P ＜ 0.01) and-4.52 (Z =42.28,P ＜0.01) in yellow race subgroup.Overall RR of response based on CGI-I was 1.64 (Z =10.39,P ＜0.01),which was 1.60 (Z =4.66,P ＜0.01) in white race subgroup,and 1.51 (Z =4.42,P ＜ 0.01) in yellow race subgroup.Overall RR for AE was 1.26 (Z =5.11,P ＜ 0.01),which was 1.26 (Z =2.27,P =0.02) in white race subgroup and 1.36 (Z =2.98,P =0.003) in yellow race subgroup.Conclusion To treat RLS,pramipexole is an effective and safe drug.The results are similar for both the white race and the yellow race.

Objective:This experiment aims to find a appropriate scaffold for Tissue Engineer- ing.Methods:The chondrocytes were cultured when they were seeded onto PGA+PLA scaffolds coat- ing with Lecithin(LEC)and Poly-l-lysine(PLYS)together and respectively.With light microscope and scanning electron microscope,the observation of the scaffolds in hydrophilia and adsorptivity to chondrocytes and the function of the cells was made.Results:The PGA scaffolds coating with LEC and PLYS have better hydrophilia and adsorptivity to the cells;on which the chodrocytes produce more ma- trices.Conclusion:LEC can chang the hydrophilia of the scaffolds;while PLYS can strengthen the ad- sorptivity of the scaffolds;the PGA coating with LEC and PLYS is an ideal scaffold in Tissue Engineer- ing.

ObjectiveTo explore the personality traits of Han Chinese women with recurrent depression.MethodsAssessed by the Big Five Inventory (BFI),a comparison research was conducted between 118 Han Chinese women with recurrent depression and 65 sex,race and culture background matched health controls.Results Han Chinese women with recurrent depression scored lower in extraversion,conscientiousness and openness ( 17.93± 5.43,30.24 ± 5.94,30.03 ± 7.33 ) than matched controls ( 20.72 ± 3.79,31.94 ± 3.84,32.75 ± 5.32 ),while scored higher in neuroticism (21.38 ± 3.91) than the later one ( 27.57 ± 6.19 ).A binary logistic regression model,with group (case vs.control) as dependent variable and extroversion,conscientiousness,openness and neuroticism as independent variables,was built to assess each personality dimension's independent impact on recurrent depression.It came out to be that only extraversion ( OR =0.881,95％ CI =0.083-0.966,P=0.007) and neuroticism ( OR =1.225,95％ CI =1.134-1.323,P ＜ 0.01 ) were statistically significantly associated with recurrent depression ( P＜ 0.05 ).ConclusionIn the big five personality model,extraversion and neuroticism might act as independent personality traits to impact Han Chinese women with recurrent depression in a positive and negative way respectively.

OBJECTIVETo investigate surgical methods and effects of unstable scapular fracture.

METHODSFrom October 2008 to August 2011, 14 patients with unstable scapular fracture were treated. There were 12 males and 2 females with an average age of 38.7 years (ranging, 21 to 55 years).The time from injury to hospitalization was 1 hour to 10 days (mean 3 days). Among patients,3 patients had scapular body fracture,4 patients had scapular neck and body fracture,4 patients had scapular neck and acromion fracture,2 patients had glenoid cavity and coracoid fracture, 1 patient with scapular spine and coracoid fracture. All patients were treated by operation, Hardegger classification system was applied to evaluate the function.

RESULTSAll patients were followed up for 2 to 36 months (mean 12.4 months). The healing time ranged from 6 to 8 weeks. No infection and internal fixation failure occurred. The effect result of Hardegger scoring system was excellent in 9 cases, good in 3 cases, fair in 2 cases.

CONCLUSIONSurgical treatment for unstable scapular fracture can reconstruct stability of shoulder joint, promote early rehabilitation of joint function, and maximally restore shoulder function.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Recovery of Function ; Scapula ; injuries ; physiopathology ; surgery ; Young Adult