Child ; Desensitization, Immunologic ; Humans ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; therapy

[Summary] The prevalence of diabetes mellitus and osteoporosis is rapidly growing and pose a serious threat to human health,. Accumulating evidence indicates that diabetes mellitus is a risk factor for osteoporosis and they could be linked by similar pathophysiological mechanisms. Antidiabetic agents may not only help to control the chronic hyperglycemia state but can also effect bone, This article reviewed the correlation between diabetes mellitus and bone metabolism and summarized the available data on skeletal effects of clinically approved antidiabetic therapies, aimed to provide the basis for clinical medicine use.

Objective To investigate the effects of ventilation strategy of permissive hypercapnia on the expression of inflammatory mediators in the patients received laparoscopic radical gastrectomy. Methods Thirty-six patients received laparoscopic radical gastrectomy were randomly divided into two groups: control group and experiment group. The patients in control group received conventional ventilation strategy [partial pressure of carbon dioxide in endexpiratory gas (P<,ErCO2) 34.5-45.0 mm Hg (1 mm Hg =0.133 kPa),pH7.35-7.45], and patients in experiment group received ventilation strategy of permissive hypercapnia(PErCO2 49.5-60.0 mm Hg,pH7.20). Blood samples were collected respectively from the peripheral vein before anesthesia induction (T0), 1 h (T1), 3 h (T2) after operation and when operation finished (T3) for the assessment of interleukin(IL)-8, IL-6,tumor necrosis factor (TNF)- α. Results The levels of IL-8, IL-6, TNF-α at T2, T3 were higher in control group [(96.732±3.173) μg/L and (107.767±3.654) μg/L, (0.273±0.009 ) ng/L and (0.287±0.008) ng/L,(1.443±0.086)μg/L and (1.614±0.107) μg/L] than those in experiment group [(91.771±4.332) μ g/L and (97.682±4.998) μg/L, (0.231±0.008 ) ng/L and (0.241±0.006) ng/L,(1.268±0.066) μg/Land (1.428±0.058) μg/L](P<0.05 or <0.01), mean arterial pressure, partial pressure of oxygen in artery and heart rate were relative stabilization. Conclusions Ventilation strategy of permissive hypercapnia can reduce the released amount of inflammatory mediators and may be advantageous for the patients received laparoscopic radical gastrectomy.

Thyrotoxicosis in pregnancy is a common endocrine disease,and the incidence is gradually increasing.And thyroid function changes during pregnancy which brings some difficulties to diagnose.It is necessary to further understand the corresponding changes of maternal thyroid hormone levels with the progress of pregnancy.Moreover,the thyroid function in pregnancy is directly related to the pregnancy outcome.If the disease is not well controlled,it will cause damage to both the mother and the fetus,all kinds of adverse pregnancy outcomes make it become the focus of clinical attention.Therefore,this article discusses the etiology of the thyrotoxicosis,thyroid function changes in the period of pregnancy as well as the impact on pregnancy outcomes,and also makes some suggestions of the diagnosis and the treatment of the disease.

Objective To compare the effects of target-controlled infusion(TCI) of remifentanil in three different doses in thoracic patients undergoing total intravenous anesthesia.Methods Forty-five ASA Ⅰ～Ⅱ patients aged 40～60yr undergoing thoracic surgery were randomly divided into three groups.The patients were given midazolam 0.05mg/kg and artropine 0.5 mg/kg i.m.before anesthesia.Anesthesia was induced with remifentanil and propofol both given by TCI simultaneously.The target concentration of propofol was set at 3?g/ml and remifentanil at 4,6,8ng/ml(groupⅠ,Ⅱ,Ⅲ).When the patients lost conscionsness,rocuronium 0.6mg/kg was given i.v.to facilitate intubation.Anesthesia was maintained with TCI of propofol-remifentanil and intermittent i.v.boluses of rocuronium.Remifentanil target concentration maintained unchanged during anesthesia.BIS index was controlled at 45～55 by modify propofol target concentration.SBP,DBP,MAP,HR and BIS index was recorded in baseline(T0),before intubation(T1),intubation(T2),skin incision(T3),the opening of the chest(T4),skin closuer(T5),extubation(T6).Vein blood samples were taken for determination of plasma concentration of epinephrine(E) and norepinephrine(NE) by ELASA.Results SBP,DBP,MAP,HR and plasma NE concentration at T2,T3,T4,T5 were higher than T0 in group Ⅰ(P

AIM: To investigate the effect of intravitreal injection of anti-vascular endothelial growth factor (VEGF) drug Bevacizumab on connective tissue growth factor(CTGF) and pigment epithelium derived factor (PEDF) in proliferative membranes in patients with proliferative diabetic retinopathy (PDR).METHODS: From January 2015 to December 2016, 117 patients (126 eyes) with PDR were analyzed using the case-control study.The selected cases were randomly divided into two groups, respectively, Group A of 60 cases (63 eyes) and Group B of 57 cases (63 eyes).The Group A was treated with vitrectomy alone, while the Group B received intravitreal injection of 0.05mL/1.25mg bevacizumab before vitrectomy.The peeled epiretinal membranes in patients were stained and then the histopathological changes were observed for primitive cells and angiogenesis, the expression of CTGF and PEDF were tested.RESULTS: The expression of CTGF and PEDF in the proliferative membrane of the two groups were expressed in the cytoplasm.The Group A showed positive expression in 38 cases, the positive rate was 60.3%.Compared with Group A, the positive expression rate of CTGF in Group B (92.1%) was significantly higher (P<0.05).The positive expression rates of PEDF in the two groups were 90.5% and 95.2% respectively, and there was no significant difference between the two groups (P>0.05).CONCLUSION: In patients with PDR after intravitreal injection of bevacizumab, the retinal neovascularization is significantly reduced, which is conducive to vitrectomy.The positive expression rate of CTGF significantly increased in patients with PDR after intravitreal injection of bevacizumab, but there was no significant change in the expression of PEDF in the anterior membrane.

AIM: To study the effect of intravitreal injection of anti-vascular endothelial growth factor (VEGF) on best corrected visual acuity (BCVA) and multifocal-electroretinogram (mfERG) before and after treatment for choroidal neovascular disease.METHODS: A total of 264 patients (332 eyes) with macular neovascularization (MCNV) and idiopathic choroidal neovascular disease (ICNV) who underwent pathologic myopia from January 2015 to January 2017 were enrolled in this study.Intraocular pressure and BCVA, fundus using 90D front mirror and slit lamp detection, and the fundus photograph, OCT, ICGA and FFA angiography, mfERG detection were taken.One month after the drug, 1mo after the final treatment, we recorded BCVA, intraocular pressure and mfERG and so on.RESULTS: Ranibizumab was injected into the 254 eyes, and 78 eyes were injected with conbercept.There were 37 eyes injected once, 147 eyes were injected twice, 72 eyes were injected 3 times, 57 eyes were injected 4 times, 19 eyes 5 times.There were no significant differences on intraocular pressure between the two groups (P>0.05).The BCVA before treatment was significantly different compared with those 1mo after treatment and 1mo after the final treatment (P>0.05).The amplitude of Ring1, Ring2 and Ring4 increased after treatment, the difference was statistically significant.(P<0.05).The amplitude of Ring3 and Ring5 increased at 1mo after final treatment(P<0.05).CONCLUSION:Intravitreal injection of anti-VEGF drugs has a significant effect on BCVA and mf ERG in patients with choroidal neovascular disease and is safe.

Objective To investigate the effect of methylprednisolone pulse therapy on spinal nerve functions in patients with acute spinal cord injury (ASCI) and evaluate its safety. Methods 200 patients with ASCI treated in our hospital from January 2010 to December 2016 were selected and were randomly divided into two groups,with 100 cases each group. The patients in control group were treated with routine basic treatment while patients in the study group were treated with methylprednisolone pulse therapy. On the basis of the American spinal cord injury Society scoring criteria (ASIA), the neurological functional recovery scores were performed were scored before and 6 weeks after treatment between the two groups and the adverse reactions were recorded. Results The scores of sensory and motor function of the patients in the two groups were higher than those before the treatment and there was statistical difference (P<0.05), and the scores in the study group was significantly higher than those in the control group, and the difference between the two grouPs was statistically significant (P<0.05). The incidence of adverse reactions in the study group (25.00％) was significantly higher than that in the control group (10.00％), and the difference was statistically significant (P<0.05). The incidence of lung infection and gastrointestinal reaction in the study group were significantly higher than those in the control group and there were statistical difference (P<0.05). Conclusion Methylprednisolone pulse therapy has significant effect on the recovery of neurological function in patients with ASCI, but the incidence of adverse reactions is high, so it is necessary to strengthen the monitoring and intervention in clinic.

Pyroptosis is a newly discovered form of programmed cell death, which has a close relationship with infectious diseases and spontaneous inflammatory disease and autoimmune disease.Gasdermin-D is the effector of pyroptosis.Inflammatory caspases cleave Gasdermin-D, break the structural autoinhibition and active the pore-forming activity of Gasdermin-D.Gasdermin-D-N domain is the active form of Gasdermin-D.Oligomerized Gasdermin-D-N domain forms membrane pores.Both pyroptosis and necroptosis can form pores.In this article, the progress of the research on pyroptosis, the involvement of Gasdermin-D in the molecular mechanism of pyroptosis, the distinguishment of pyroptosis from necroptosis and pyroptosis-related diseases are reviewed.

There are mounting evidences demonstrating that obesity and osteoporosis pose a daunting threat on global public health problem, given their morbidity and mortality. Ω-3 polyunsaturated fatty acids ,besides as a source of energy, may regulate the cellular signal transduction pathway to produce specific patterns of gene expression, and protect from complications of obesity and osteoporosis . This article reviewed the correlation between obesity and osteoporosis, and summarized the effects and potential mechanism of ω-3 polyunsaturated fatty acids on fat metabolism and bone metabolism from both animal experiments and epidemiological studies.