Objective To investigate the role of allergen specific IgE in the child with recurrent auergic purpura,and to detect the relation between all kinds of allergen and the disease.Methods The serum specific IgE of allergen detected by ELISA in 100 cases of the child with recurrent auergic purpura.Results 81 cases of serum allergen-specific IgE were over than 50ku/L(81%).52 cases(52%)were positive reaction to more than two kinds of allergens and 29 cases(29%)were positive reaction to one kind of allergen.Several familiar aeroallergen mixed molds (19/100),dermatophagoides(12/100)and mugwort pollens(9/100).The most familiar food fish(28/100).shrimpand crab(22/100),milk(18/100).protein(11/100).Conclusion It suggests that aeroallergens,fish,shrimp and crab play an important role in the pathogenesis of repeating child anaphy lactic purpura.Mixed molds and protein foods are important pathogens to the disease.To detect the serum specific IgE could help screen allergens,and have important role to prevent disease.

Objective To evaluate the efficacy and safety of near-infrared light combined with tacrolimus 0.1％ ointment in the treatment of facial glucocorticoid-dependent dermatitis.Methods A total of 68 patients with facial glucocorticoid-dependent dermatitis were enrolled from Department of Dermatology of Yantai Yuhuangding Hospital between December 2014 and December 2015,and randomly and equally divided into treatment group and combination group by a random number table.The treatment group was treated topically with tacrolimus ointment twice a day for 4 weeks.Besides the treatment with tacrolimus ointment,the combination group was irradiated with near-infrared light once a week for 4 sessions.After 4-week treatment,improvement in clinical manifestations such as itching and burning sensation was evaluated,so was the therapeutic effect.Results The combination group showed significantly higher response rate (85.3％ [29/34]) compared with the treatment group (61.8％ [21/34],x2 =4.84,P ＜ 0.05).Additionally,response rates for itching and burning sensation,erythema,scales and papules were all significantly higher in the combination group than in the treatment group (x2 =4.84,6.35,8.42 and 5.52,respectively,all P ＜ 0.05).Conclusion Near-infrared light combined with tacrolimus ointment is effective and safe for the treatment of facial glucocorticoid-dependent dermatitis.

Objective: To explore the growth inhibition and apoptosis-inducing effects of apigenin in human gastric cancer SGC-7901 cells. Method: MTT and flowcytometry were used to detect the growth inhibition and cell cycle distribution in apigenin-treated SGC-7901 cells respectively. DAPI fluorescence staining and DNA ladder assay were applied to study the pro-apoptosis effects of apigenin. The expression of apoptosis relative proteins, caspase-3 and Bcl-2, were analyzed by using Western blotting. Results: Apigenin treatment significantly inhibited the growth of human gastric cancer cell SGC-7901 and markedly caused their apoptosis following activation of caspase-3 and downregulation of Bcl-2 protein expression. Conclusion: The activation of caspase-3 and downregulation of apoptosis relative protein Bcl-2 expression were the possible mechanism of apigenin induced growth inhibition and apoptosis in SGC-7901 cells.

Objective To investigate the comprehensive prevention strategy in the prevention of oral mucositis (OM) during allogeneic hematopoietic stem cell transplantation (HSCT). Methods A total of 721 patients who received HSCT from January 2010 to December 2011 at the Institute of Hematology, Peking University were enrolled. All the patients received the comprehensive prevention strategy of OM. Results A total of 315 patients (43.7 percents) suffered from OM during HSCT, the median time from HSCT to OM occurrence was 5 days. There were 173 (54.9 percents), 91(28.9 percents), 37(11.7 percents), and 14(4.4 percents) patients suffered from gradeⅠ,Ⅱ,Ⅲ, and IV OM, respectively. Tongue OM was most common. A total of 111 patients suffered from multiple OM (≥2 locations). Multiplicity showed that duration of agranulocytosis≥15 days was the only independent risk factor of OM in HSCT [ hazard ratio (HR) value 1.5, P<0.05 ]. Neutrophil engraftment time≥12 days was significantly associated with prolonged OM (≥8 days) (HR=2.1, P<0.05). Patient age ≥20 was independent risk factor for occurrance of grade Ⅲ-Ⅳ OM (HR=2.7, P<0.05). Conclusions Comprehensive prevention strategy can overcome the risk factors of OM and prevent the occurrence of OM during HSCT.

Objective To estimate the correlations between chronic idiopathic urticaria (CIU) development and interrelated autoantibodies,including anti-high affinity immunoglobulin E receptor (anti-FcεRI) antibody,anti-immunoglobulin E (anti-IgE) antibody,anti-Helicobacter pylori (HP) antibody and antithyroglobulin antibody (TGAb).Methods This study included 100 patients with CIU,100 patients with acute urticaria (AU) and 100 healthy controls.Autologous serum skin test (ASST) was performed and allergens were detected by fluorescence-based enzyme linked immunosorbent assay (ELISA) in each subject.Serum levels of total IgE,anti-FcεRI antibody,anti-IgE antibody,anti-HP antibody and TGAb were measured.Chi-square test,analysis of variance,and Wilcoxon rank sum test were conducted for statistical analysis.Results The positivity rate of ASST was 53％,12％ and 0 respectively in patients with CIU,patients with AU and healthy controls,respectively.Food or inhalant allergens were detected in 86％ of the patients with AU,but not detected in any of the patients with CIU or healthy controls.Patients with CIU showed significantly higher levels of anti-FcεRI antibody and anti-IgE antibody compared with patients with AU and healthy controls (all P ＜ 0.05).The serum IgE level in healthy controls was statistically lower than that in patients with AU (T =226.00,P ＜ 0.05),but higher than that in patients with CIU (T =190.00,P ＜ 0.05).ASST-positive patients with CIU had a higher level of serum anti-FcεRI antibody (T =101.73,P ＜ 0.05),but a similar level of serum anti-IgE antibody compared with ASST-negative patients with CIU (T =312.04,P ＞ 0.05).No significant differences were observed in the positivity rate of anti-HP antibody (29％,19％ and 23％,P ＞ 0.05) or TGAb (18％,15％ and 11％,P ＞ 0.05) between the patients with CIU,patients with AU and healthy controls.Both anti-HP antibody-positive patients and TGAb-positive patients with CIU showed a significantly higher positivity rate of anti-FcεRI antibody (all P ＜ 0.01),but a similar positivity rate of anti-IgE antibody compared with the patients with AU and healthy controls (all P ＞ 0.05).Conclusions Anti-FcεRI antibody and anti-IgE antibody are present in patients with CIU,and may play a certain role in the pathogenesis of CIU.

Objective To investigate the relationship between anti-Helicobacter pylori (Hp) antibodies and development of chronic urticaria (CU).Methods Fifty CU patients with positive 13C-urea breath test and anti-Hp antibodies,as well as 50 healthy human controls were recruited in this study.Serum samples were collected from all the subjects.The samples from the patients were subjected to tests for anti-high affinity IgE receptor (anti-FcεRI) and-IgE antibodies.Human mast cells (HMCs) were classified into several parts to be incubated with the sera of patients with CU,the sera of healthy controls with anti-IgE and-FcεRI antibodies respectively for 20 minutes.Those incubated with the sera of healthy controls without these antibodies served as the control.Subsequently,the levels of histamine released by HMCs were measured by enzyme-linked immunosorbent assay (ELISA).Results The sera of CU patients showed a stronger ability to activate HMCs to release histamine than those of healthy controls ((3.13 ± 0.93) μg/L vs (2.92 ± 0.75) μg/L,t =2.39,P ＜ 0.05).Anti-FcεRI antibodies were detected in 4 patients,and antiIgE antibodies in 3 patients.A significant increase was observed in the levels of histamine released by HMCs incubated with anti-FcεRI antibody-positive and anti-IgE antibody-positive patient-derived sera (t =4.82,6.34,respectively,both P ＜ 0.01),but not in those incubated with patient-derived sera only positive for anti-Hp antibodies (t =1.74,P ＞ 0.05) compared with those incubated with healthy control-derived sera.In comparison with the antibody-free healthy control-derived sera,those with anti-Hp IgG antibodies showed no significant effect on the release of histamines by HMCs (t =1.95,P ＞ 0.05),whereas those with anti-FcεRI antibodies and anti-IgE antibodies exhibited an obvious promoting effect (t =3.72,3.02,respectively,both P ＜ 0.01).Conclusions The anti-Hp antibodies appears to have no role in the pathogenesis of CU,but the presence of anti-FcεRI and anti-IgE antibodies may contribute to the initiation of CU in patients with Hp infection.

Objective :To explore therapeutic effect of recombinant human brain natriuretic peptide (rhBNP) and le‐vosimendan on patients with acute myocardial infarction (AMI) undergoing emergency percutaneous coronary inter‐vention (PCI) and its safety .Methods :A total of 110 AMI patients undergoing PCI ,who were treated in our hospi‐tal from Jan 2017 to Oct 2017 ,were selected .Patients were randomly divided into rhBNP group (n＝53 ,received rhBNP based on routine medication ) and levosimendan group (n＝57 ,received levosimendan based on routine medi‐cation) ,both groups were treated for 7d.The 24h urine volume ,heart rate (HR ) ,respiratory rate (RR ) before and 24h after PCI ,level of brain natriuretic peptide (BNP) , LVEF , LVEDd ,LVESd before and 7d after PCI were observed and compared between two groups .Results : Compared with before PCI on 24h after PCI ,there was significant rise in 24h urine volume ,and significant reductions in HR and RR in two groups , P＝0.001 all.Com‐pared with levosimendan group on 24h after PCI ,there was significant rise in 24h urine volume [(1732.00 ± 243. 75) ml vs.(1854.23 ± 264.24) ml] ,and significant reductions in HR [ (79.24 ± 9.43) beats／min vs.(73.43 ± 8.24) beats／min] and RR [ (18. 32 ± 4. 76) times／min vs.(15.32 ± 4. 23) times／min ] in rhBNP group ( P＜0. 05 or ＜0.01) ;on 7d after PCI ,compared with rhBNP group , LVEF [ (40.45 ± 5. 65)% vs .(44.75 ± 5.87)%] , BNP lev‐el [(256. 54 ± 9.38) pg／ml vs.(395.25 ± 8. 34) pg／ml] was significantly higher ,and LVESd [(47. 87 ± 4.65) mm vs.(43. 83 ± 3.65) mm] were significantly lower ( P＝0.001 all) in levosimendan group .There was no significant difference in incidence rates of adverse reactions between two groups after PCI ( P＞0.05 all).Conclusion :Myo‐cardial contraction capacity of levosimendan is significantly better than that of rhBNP ,while rhBNP is significantly better than levosimendan in reducing BNP level and improving renal function .

Objective:To explore the prolonged therapeutic regimen for patients with plaque psoriasis, who showed a positive response to 4-week treatment with tazarotene/betamethasone dipropionate cream, but were not completely cured.Methods:A multicenter, randomized, open-labelled, parallel-controlled clinical study was conducted. A total of 232 patients with plaque psoriasis were collected, who showed a positive response to previous 4-week treatment with 0.05%/0.05% tazarotene/betamethasone dipropionate cream, but were not completely cured with the psoriasis area and severity index[PASI] improvement rate being 50%-90%. At week 5, they were randomly and equally divided into 2 groups: test group receiving treatment with 0.05%/0.05% tazarotene/betamethasone dipropionate cream once a day, and control group receiving a sequential regimen of 0.05% tazarotene gel on weekdays once a day followed by 0.05%/0.05% tazarotene/betamethasone dipropionate cream on weekends once a day. After 2-and 4-week prolonged treatment, the efficacy and safety of the 2 therapeutic regimens were evaluated and compared. Measurement data were compared between 2 groups by using covariance analysis or t test, and enumeration data were compared by using chi-square test. Results:From the 5th to the 8th week, 200 out of the 232 patients completed the treatment. Data collected from 110 patients in the test group and 112 in the control group were enrolled into the full analysis set, and those from both 113 patients in the test group and control group were enrolled into safety analysis set. After consecutive 6-and 8-week treatment, the decline rates of the PASI score were 73.05% ± 16.69% and 78.46% ± 15.40% respectively in the test group, which were significantly higher than those in the control group (66.73% ± 21.77%, 67.02% ± 34.19%, respectively, both P < 0.05) . After 6-week treatment, the proportion of subjects who achieved PASI90 was significantly higher in the test group (14 cases, 12.7%) than in the control group (5 cases, 4.5%, χ2=4.842, P=0.028) ; After 8-week treatment, the proportions of subjects who achieved PASI75 and PASI90 (61.8%, 23.6%, respectively) were significantly higher in the test group than in the control group (48.2%, 12.5%, respectively, both P < 0.05) . During the consecutive 8-week treatment, there was no significant difference in the incidence rate of adverse reactions between the test group (15.0%) and control group (23.9%, χ2=2.822, P=0.093) . Conclusion:For patients who showed a positive response to 4-week treatment with 0.05%/0.05% tazarotene/betamethasone dipropionate cream, but were not completely cured, the continuous use of 0.05%/0.05% tazarotene/betamethasone dipropionate cream for 4 weeks is a superior therapeutic regimen compared with the sequential regimen of 0.05% tazarotene gel followed by 0.05%/0.05% tazarotene/betamethasone dipropionate cream.

Objective:To study the risk factors of adverse pregnancy outcomes for induced abortion of cesarean scar pregnancy in midtrimester.Methods:A national multicenter retrospective study was conducted. A total of 154 singletons pregnant women with cesarean scar pregnancy during the second trimester induced abortion by various reasons in 12 tertiary A hospitals were selected, their pregnant outcomes were observed and the risk factors of serious adverse outcomes were analyzed with univariate and multivariate logstic regression; the role of ultrasound and MRI in predicting placenta accreta and severe adverse outcomes was evaluated, the effectiveness of uterine artery embolization (UAE) in preventing hemorrhage in pregnant women with and without placenta accreta was compared.Results:Among 154 subjects, the rate of placenta accreta was 42.2% (65/154), the rate of postpartum hemorrhage≥1 000 ml was 39.0% (60/154), the rate of hysterectomy was 14.9% (23/154), the rate of uterine rupture was 0.6% (1/154). The risk factor of postpartum hemorrhage≥1 000 ml and hysterectomy was placenta accreta ( P<0.01). For each increase in the number of parity, the risk of placenta accreta increased 2.385 times (95% CI: 1.046-5.439; P=0.039); and the risk of placenta accreta decreased with increasing ultrasound measurement of scar myometrium thickness ( OR=0.033, 95% CI: 0.001-0.762; P=0.033). The amount of postpartum hemorrhage and hysterectomy rate in the group with placenta accreta diagnosed by ultrasound combined with MRI were not significantly different from those in the group with placenta accreta diagnosed by ultrasound only or MRI only (all P>0.05). For pregnant women with placenta accreta, there were no significant difference in the amount of bleeding and hysterectomy rate between the UAE group [median: 1 300 ml; 34% (16/47)] and the non-embolization group (all P>0.05); in pregnant women without placenta accreta, the amount of bleeding in the UAE group was lower than that in the non-embolization group (median: 100 vs 600 ml; P<0.01), but there was no significant difference in hysterectomy rate [2% (1/56) vs 9% (3/33); P>0.05]. Conclusions:(1) Placenta accreta is the only risk factor of postpartum hemorrhage≥1 000 ml with hysterectomy for induced abortion of cesarean scar pregnancy in midtrimester; multi-parity and ultrasound measurement of scar myometrium thickness are risk factors for placenta accreta. (2) The technique of using ultrasound and MRI in predicting placenta accreta of cesarean scar pregnancy needs to be improved. (3) It is necessary to discuss of UAE in preventing postpartum hemorrhage for induced abortion of cesarean scar pregnancy in midtrimester.

Objective:To study the risk factors of adverse pregnancy outcomes for the diagnosis and treatment of pregnancy after cesarean section complicated with placenta previa.Methods:A national multicenter retrospective study was conducted to select a total of 747 pregnant women with the third trimester singleton pregnancy after cesarean section complicated with placenta previa from 12 tertiary hospitals in January 1st to December 31st, 2018. The risk factors of severe adverse outcomes [hysterectomy, intraoperative blood loss ≥1 000 ml, intraoperative diagnosis of placenta accreta spectrum disorders (PAS)] in pregnant women with second pregnancy complicated with placenta previa after cesarean section were investigated by logistic regression analysis. The roles of prenatal ultrasonography and magnetic resonance imaging (MRI) in the prediction of PAS and severe adverse outcomes were observed. According to whether vascular intervention was performed (uterine artery embolization or abdominal aortic balloon occlusion), the pregnant women were divided into the blocked group and the unblocked group, and the maternal and infant perinatal outcomes between the two groups were compared.Results:(1) General information: the hysterectomy rate of 747 pregnant women with second pregnancy complicated with placenta previa after cesarean section was 10.4% (78/747), the intraoperative blood loss ≥1 000 ml in 55.8% (417/747), and PAS was confirmed in 47.5% (355/747). The incidence of uterine rupture was 0.8% (6/747). (2) Analysis of risk factors for severe adverse outcomes: based on binary unconditioned logistic regression univariate and multivariate analysis, the risk factors for hysterectomy were the mode of vascular embolization and intraoperative blood loss. The probability of hysterectomy with uterine artery embolization was 5.319 times higher than that with abdominal aortic balloon occlusion (95% CI: 1.346-21.018). The risk factors of intraoperative blood loss ≥1 000 ml were the number of cesarean section delivery, ultrasonography indicated PAS and suspected PAS, intraoperative PAS and complete placenta previa. The risk factors for intraoperative PAS were uterine scar thickness, ultrasonography indicated PAS and suspected PAS, MRI indicated PAS and suspected PAS, and complete placenta previa. (3) The roles of ultrasonography and MRI in predicting PAS: the sensitivity and specificity of ultrasonography in predicting PAS were 47.5% and 88.4%; the kappa value was 0.279 ( P<0.001), with fair agreement. The sensitivity and specificity of MRI to predict PAS were 79.2% and 97.8%, respectively. The kappa value was 0.702 ( P<0.001), indicating a good agreement. The intraoperative blood loss and hysterectomy rate of pregnant women with PAS indicated by ultrasonography and MRI were significantly higher than those with PAS only by ultrasonography or MRI. (4) Influence of vascular occlusion on pregnancy outcome: there were no significant differences in intraoperative blood loss and incidence of intraoperative bleeding ≥1 000 ml between the blocked group and the unblocked group (all P>0.05). There was no significant difference in intraoperative blood loss between the pregnant women with abdominal aortic balloon occlusion, uterine artery embolization and those without occlusion ( P=0.409). The hysterectomy rate of pregnant women with uterine artery embolization was significantly higher than those with abdominal aortic balloon occlusion [39.3% (22/56) vs 10.0% (5/50), P=0.001]. Conclusions:In the third trimester of pregnancy with placenta previa after cesarean section, MRI examination has better consistency in predicting PAS than ultrasonography examination. Ultrasonography examination combined with MRI examination could effectively predict the hysterectomy rate and intraoperative blood loss. Vascular occlusion could not reduce the amount of intraoperative blood loss. The hysterectomy rate of pregnant women with uterine artery embolization is higher than those with abdominal aortic balloon occlusion.