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 analyze genetic diversity of Fluconazole(FLZ)-resistant and -susceptible Candida albicans(C. albicans) strains isolated from patients with Sjgren's Syndrome (SS). Methods:30 C.albicans strains were isolated from the patients with SS and identified using standard criteria. Microdilution method was performed to determine the minimum inhibitory concentrations (MICs) of C.albicans to FLZ. A composite genotype was generated for each strain through random amplification of polymorphic DNA (RAPD) using three different primers, RSD10, RSD11 and RSD12. Results:The DNA fingerprinting profiles indicated genetic diversity amongst both the FLZ-resistant as well as -susceptible isolates, and no specific features emerged distinguishing the drug-resistant and -susceptible groups. Conclusion:These observations cast doubt on the theory of a clonal origin of FLZ-resistant C. albicans isolates. The emergence of FLZ resistance in SS patients may be associated with continuous exposure to FLZ.

Objective To examine clinical features, neuroimaging presentation and treatment of intracranial fungal granulomas (ICFG) in order to improve the accuracy rates of diagnosis and cure. Methods Three pathologically proven cases with ICFG were retrospectively analyzed. Cases of ICFG reported in literature were also summarized. Results Among the 3 patients with ICFG, 1 patient had a history of head trauma and craniotomy and 1 had a history of type 2 diabetes mellitus and a long history of exposure to doves. In all 3 patients, the symptoms started with headache and vomiting, accompanied by low-grade fever, convulsion, and cranial nerve deficits. Intracranial mass lesion was revealed on brain computed tomography (CT) scan and (or) magnetic resonance imaging (MRI) with or without intravenous contrast. CT scan showed low-density lesions and granulations with ring and homogenous enhancement, indicating fungal abscesses. MRI in all 3 cases showed one or multiple circumscribed intracranial space-occupying lesion, with ring, heterogeneous contrast enhancement and perilesional edema. The treatments were initiated with craniotomy and surgical resection of granulations followed by intravenous injection of amphotericin B (AMB) combined with fluconazole. The daily administration of AMB was increased gradually from 0.25-1.50 mg/kg and the total dosage of 2-4 g should be achieved within 3 months. The combination therapy with fluconazole (400 mg/d ) was also given by intravenous injection. To increase penetration into cerebrospinal fluid, intrathecal injection of AMB had also been given at the maximum dosage of 1 mg every time, twice a week. Two patients were administered fluconazole (200 mg/d ) orally for 3, 6 months consecutively after completing the combination therapy of AMB with fluconazole, while the other patient refused continuous antifungal treatment 1 month postoperatively. All 3 patients were followed up for a period between 3, 24, 48 months. The 2 patients that completed full antifungal treatment were cured without recurrence. The other patient had improved transiently after operation but died after 3 months. Conclusions Because no distinct chnical and neuroimaging features are presented in ICFG, it is difficult to diagnose preoperatively. Indications for surgery include diagnosis, relief mass effect and increase efficiency of drug treatment. Use of appropriate and completed antifungal treatment decreases mortality. The treatment requires continued and long-term administration of antifungal medication to prevent relapses, whether granulomas are totally removed or not.

Objective:To analyze the value of pepsinⅠ( PGⅠ) , pepsinⅡ( PGⅡ) , gastrin-17 ( G-17 ) diagnostic and Helicobacter pylori( Hp IgG) antibody in screening chronic atrophic gastritis and gastric cancer.Methods:90 patients with an upset stomach in our hospital from May 2014 to May 2015 were selected for the study, according to the pathological diagnosis which were divided into normal control group( including chronic non-atrophic gastritis) ,chronic atrophic gastritis group and gastric cancer,30 cases in each group.The level of PGⅠ, PGⅡ, G-17 and Hp IgG antibody positive rate in the three groups of patients were compared.Results:The level of PGⅠ,PGⅡin gastric cancer patients were lower than the control group and chronic atrophic gastritis group.And the index of chronic atrophic gastritis patients were lower than control group.The level of G-17 in gastric cancer group was higher than chronic atrophic gastritis group and the control group, and chronic atrophic gastritis group and the control group had no significant difference.The Hp IgG antibody positive rate in gastric cancer group was significantly higher than other two grups.The level of PGⅠand PGⅡin Hp-infected patients were lower than uninfected Hp patients,and the level of G-17 was higher than uninfected Hp patients.The level of PGⅠ, PGⅡ were significantly negatively correlated with age, pathological stage and metastasis, and positive related with the degree of differentiation;but the level of G-17 and Hp IgG antibody rate were positive related with age,pathological stage and metastasis, and negatively correlated with the degree of differentiation.Conclusion: PGⅠ, PGⅡ and Hp IgG antibody screening have a good diagnostic value in chronic atrophic gastritis and gastric cancer,and better diagnostic value of gastric cancer,G-17 diagnostic value of gastric cancer is much better than the chronic atrophic gastritis;and the level of PGⅠ,PGⅡ,G-17 and IgG antibody positive rate are closely related to the clinicopathological features of gastric cancer patients.

Objective To study changes of auditory brainstem evoked potentials (ABR)and the expression of glial fibrillary acidic protein (GFAP)during the critical period of the development of the auditory cortex in rats. Methods Fifty Sprague - Dawley (SD)rat pups were divided into five groups(n=10 per group):postnatal 14 days group,postnatal 21 days group,postnatal 28 days group,postnatal 35 days group and postnatal 42 days group.The rats were decapitated after the evaluation of ABR.The auditory cortex was taken and immunohisto-chemical staining was used to detect the expression of GFAP in rat auditory cortex in each group.The protein ex-pressions of GFAP in rat auditory cortex in each group were tested by western blot methods respectively.ResuIts The ABR thresholds gradually decreased along with the increasing days after the birth.The average ABR thresholds in postnatal 14 days group,postnatal 21 days group,postnatal 28 days group,postnatal 35 days group and postnatal 42 days group were (84.5 ± 4.97)dB SPL ,(70.5±3.69)dB SPL ,(58.5±5.80)dB SPL,(37.0±4.83)dB SPL and(35.5±3.69)dB SPL,respectively.There were no significant differences in ABR thresholds between the postnatal 35 days group and the postnatal 42 days group (P>0.05),whereas,significant differences were found among the other groups(P<0.05 or P<0.01.GFAP expression in auditory cortex gradually increased in all five groups.The average integrated optical density (IOD)of postnatal 14 days group,postnatal 21 days group,postnatal 28 days group,postnatal 35 days group and postnatal 42 days group were 474.36±234.56,1465.93 ±474.96,2163.06 ± 353.36,6572.01±808.88 and 7244.37±932.90,respectively.The differences among all five groups were statisti-cally significant (P<0.05 orP<0.01 ).The protein levels of GFAP in the auditory cortex of postnatal 14 days group,postnatal 21 days group,postnatal 28 days group,postnatal 35 days group and postnatal 42 days group were 1.00±0.06,3.07±0.07,4.92±0.05,6.88±0.03 and 8.92±0.04.The differences among all five groups were sta-tistically significant (P<0.05).ConcIusion The ABR threshold gradually decreased and GFAP expression in audi-tory cortex gradually increased from postnatal 14 days to postnatal 42 days ,suggesting that astrocytes may promote the development and maturation of the auditory cortex and the auditory central system in rats.

Objective To observe the clinical efficacy and safety of Chushi Huowei Decoction in treating inflammation of gastric relict of spleen-stomach damp heat type. Methods Totally 62 patients with inflammation of gastric relict were divided into treatment group and control group with random number table, 31 patients in each group. The control group was given hydrotalcite and the treatment group was treated by adding of Chushi Huowei Decoction. After eight-week treatment, the clinical efficacy, gastric mucosal lesions efficacy, and gastric mucosal pathology efficacy of the two groups were compared. Results Eight-weeks later, traditional Chinese medicine symptom scores of both groups were obviously lower than those before treatment (P<0.01). And the decrease in the treatment group was more obvious than that in the control group (P<0.01). Curative effects of gastric mucosal lesions and pathologic condition in treatment group were better than those in the control group (P<0.05, P<0.01). Neither groups had any adverse reaction. Conclusion Chushi Huowei Decoction has reliable therapeutic effect and safety in treating inflammation of gastric relict of spleen-stomach damp heat type.

OBJECTIVE To investigate the status of hospital infection of elderly in internal medicine,in order to prevent and control hospital infection of them.METHODS A restrospective survey on 157 cases of hospital(infection) of elderly from Aug 2003 to Apr 2005 was conducted in internal medicine.(RESULTS)The results showed that the high risk wards were in geriatrics,neurology,endocrinology and(cardiovascular) departments.The high risk season was in winter.Respiratory tract was the most common(infective) site.Fungi were the main pathogens.CONCLUSIONS The hospital infection of elderly should be(controlled) better,geriatrics department is the key(control) unit.Winter is the key control season.The diagnostic level of clinician about the hospital(infection) of(edlerly) should be enhanced and the antibiotic must be used reasonably.

Objective To observe the effects of long term injection sodium salicylate on the auditory brain-stem response(ABR)and expression of glutamic acid decarboxylase -67(GAD67) in rat inferior colliculus .Methods Eighteen healthy Wistar rats were randomly divided into three groups :the sodium salicylate group (intramuscular injection of 10% sodium salicylate ,175 mg/kg ,twice daliy for 28 days) ,the saline group (intramuscular injection with saline on same does at the same time) ,the control group (without any treatment) .The rats received ABR after modeling ,then were decapitated and inferior colliculus tissues were stripped .Western blot was used to study the dif-ferent expression of GAD67 protein levels in the three groups .Results Compared with the saline group and control group ,ABR thresholds of the sodium salicylate group were significantly elevated and latency of wave Ⅲ was aslo sig-nificantly prolonged(P<0 .01) ,while there was no significant difference between the saline group and the control group(P>0 .05) .The inferior colliculus GAD67 protein expression level of sodium salicylate group was significantly higher than the saline group and control group(P<0 .01) ,while there was no significant difference between the saline group and the control group(P>0 .05) .Conclusion Long term injection of sodium salicylate can cause a change in the inferior colliculus of GAD67 protein expression and the up regulation of GAD67 expression may occur as a com-pensatory response to increase inhibiting effect .The change of GAD67 protein expression is likely as a compensatory and regulatory mechanisms for sodium salicylate ototoxicity .

Objective: To explore the impact of atrial fibrillation (AF) on clinical outcomes in patients with cardiac resynchronization therapy (CRT). Methods: A total of 258 arrhythmia patients who received CRT in our hospital from 2010-01 to 2014-12 were retrospectively enrolled. According to AF occurrence, the patients were divided into 2 groups: AF group,n=42 and Non-AF group,n=216. The end point events were deifned by heart failure (HF) re-admission and all-cause death (including heart transplantation). Survival curve was drawn by Kaplan-Meier method, clinical prognosis was comparedbetween 2 groups with log-rank test and the impact of AF on end point prediction was analyzed by uni- and multivariate Cox proportional-hazards regression models. Results: There were 16.3% (42/258) patients combining AF. The following indexes were statistically different between AF group and Non-AF group: patients' age, the ratios of male gender and left bundle branch block (LBBB), eGFR, blood levels of creatinine, uric acid, big endothelin-1, left atrial diameter and application of amiodarone. With the median of 22 months follow-up study, there were 33/258 (12.8%) patients died, 5 (1.9%) received heart transplantation and 72 (27.9%) with HF re-admission. Survival analysisindicated that HF re-admission rate in AF group was higher than Non-AF group (χ2=6.651,P=0.010), all cause mortality was similar between 2 groups (χ2=0.528,P=0.468). Univariate Cox proportional-hazards regression analysis showed that AF, LBBB, higher blood levels of creatinine, big endothelin-1 and large left atrium were the suspiciousrisk factors for HF re-admission; increased blood levels of creatinine, big endothelin-1 and large left atrium were thesuspiciousrisk factors for all cause death. Multivariate Cox proportional-hazards regression analysis presented that AF was not the independent risk factor for HF re-admission and all-cause death, while largeleft atrium was the independent risk factor for HF re-admission (HR=1.041, 95% CI 1.007-1.075,P=0.018); large left atrium and increased serum creatinine were the independent risk factors for all cause death (HR=1.045, 95% CI 1.001-1.091,P=0.048) and (HR=1.008, 95% CI 1.001-1.015,P=0.035) respectively. Conclusion: AF was associated with the higher rate of HF re-admission in CRT patients; while no clear evidencesupported that AF was the independent risk factor for HF re-admission and all cause death in CRT patients.

Objective: To compare the clinical characteristics and plasma level of N-terminal pro-brain natriuretic peptide (NT-proBNP) between the patients with hypertensive hypertrophic cardiomyopathy in elder age (HHCME) and the patients with hypertensive left ventricular hypertrophy (HTN-LVH).
Methods: Our work included 2 groups, HHCME group,n=47 and HTN-LVH group,n=44. Duplex Doppler echocardiography was performed to determine left atrial diameter (LAd), left ventricular end-diastolic dimension (LVEDd), interventricular septal thickness (IVST), left ventricular ejection fraction (LVEF), velocity of early diastolic period (VE) and velocity of end-diastolic period (VA) in mitral valve oriifce. Plasma level of NT-proBNP was measured by ELISA. The above indexes were compared between 2 groups.
Results:①Compared with HTN-LVH group, HHCME group presented decreased LVEDd and increased IVST, LVEF, allP<0.001. There were no signiifcant differences in VE/VA ratio and LAd between 2 groups, allP>0.05.②Plasma level of NT-proBNP was higher in HHCME group,P<0.01. With the adjusted age, gender, history of hypertension, LAd, IVST, left ventricular systolic and diastolic function, the level of NT-proBNP in HHCME group (1317.19 fmol/ml) was still signiifcantly higher than that in HTN-LVH group (526.19fmol/ml),P<0.01.
Conclusion: The plasma NT-proBNP level was higher in HHCME patients than that in HTN-LVH patients which indicated that HHCME patients may have worse prognosis. NT-proBNP might be helpful for differencing HHCME.