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 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 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 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 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 detect the level of plasma miR-155 in patients with pancreatic cancer and evaluate its diagnostic value for pancreatic cancer. Methods Sixty-two cases of pancreatic cancer patients, 61 patients of chronic pancreatitis and 36 normal controls were included in the study. miR-155 in the total RNA extracted from the plasma was measured using real time PCR. The diagnostic parameters and relationship of the miR-155 with clinical characteristics in pancreatic cancer patients were analyzed. Results The relative abundance of plasma miR-155 in pancreatic cancer, chronic pancreatitis and normal controls were 5.41 ±3.14,2.59 ±2.49 and 0.77 ± 1.17, and the value was significantly higher in pancreatic cancer group compared with those of chronic pancreatitis and normal group (P ＜ 0. 01 ). No significant correlation between the level of plasma miR-155 and age, sex, tumor size in pancreatic cancer patients was found. But there was a negative correlation between the level of plasma miR-155 and TNM staging (r = -0. 323, P = 0.01 ). For discriminating pancreatic cancer from normal control, the AUC ROC of miR-155 was 0. 943 (95% CI 0.902-0.985), and the sensitivity and specificity were 87.1% and 83.3%, respectively. For discriminating pancreatic cancer from chronic pancreatitis, the AUC ROC of miR-155 was 0.762 (95% CI0. 678-0. 846),and the sensitivity and specificity were 64.5% and 73.8%, respectively. For discriminating pancreatic cancer from chronic pancreatitis and normal, the AUC-ROC of miR-155 was 0. 829(95% CI0. 767-0.892), and the sensitivity and specificity were 62.9% and 84.5%, respectively. Conclusions Plasma miR-155 was significantly increased in patients with pancreatic cancer, and can be used for diagnosis of pancreatic cancer.

Objective To investigate the influence of gonadotropin-releasing hormone (GnRH) analogues on ovarian cancer and ovarian function in vivo.Methods ES-2 cells were cultured and xenotransplanted into 36 nude mice,which were divided into 6 groups:normal saline (NS) group:NS 0.1 nd/day subcutaneous injection,and then NS 0.2 ml/week peritoneal injection; cisplatin (DDP) group:NS 0.1 ml/day subcutaneous injection,and then DDP 5 mg/kg ( diluted to 0.2 ml ) per week peritoneal injection; goserelin group:100 μg goserelin ( diluted to 0.1 ml) per day subcutaneous injection,and then NS 0.2 ml/week peritoneal injection; goserelin + DDP group:100 μg goserelin ( diluted to 0.1 ml) per day subcutaneous injection,and DDP 5 mg/kg (diluted to 0.2 ml) per week peritoneal injection; cetrorelix group:100 μg cetrorelix (diluted to 0.1 ml) per day subcutaneous injection and NS 0.2 ml/week peritoneal injection; cetrorelix + DDP group:100 μg cetrorelix (diluted to 0.1 ml) per day subcutaneous injection and DDP 5 mg/kg ( diluted to 0.2 ml) per week peritoneal injection.All the peritoneal injection started from subcutaneous injection one week later.To compare the weight of nude mice,the volumes of transplanted tumors,the expression of Ki-67 antigen in transplanted tumors,the estrus,the ratio of atretic follicles,the ratio of primary and preantral follicles,the levels of serum anti-Mullerian hormone ( AMH ),folliclestimulating hormone ( FSH),estradio ( E2 ) and progesterone (P) in each group.Results There were no significant difference in the weight of nude mice among 6 groups ( P ＞ 0.05 ),which on day 29 in NS group was ( 19.8 ±2.2) g,DDP group (20.5 ± 1.4) g,gosereline group ( 19.6 ±0.9) g,goserelin + DDP group ( 19.7 ± 1.6) g,cetrorelix group (20.7 ±2.2) g,and cetrorelix + DDP group ( 19.0 ± 1.7) g.The tumor volumes of different groups on the 12th day:NS group (241 ± 179) mm3,DDP group (78 ±20) mm3,gosereline group (78 t±55) mm3,goserelin + DDP group (64 ±48) mm3,cetrorelix group (78 ±64) mm3,or cetrorelix + DDP group (70 ± 19) mm3,in which there were significant difference between NS group and the other groups ( P ＜ 0.05 ) ; and the same result was obtained on day 15,19,22,26 and 29 ( P ＜ 0.05 ).The expression of Ki-67 in NS group was ( 33 ± 10 ) ％,in which it was higher than those in DDP group 3.5％,goserelin group 8.8％,goserelin + DDP group 1.5％,cetrorelix group (23 ± 11 ) ％,or cetrorelix + DDP group ( 8 ± 6 ) ％ ( P ＜ 0.05 ).The ratio of primary and preantral follicles in goserehn group was (71.5 ± 8.1 ) ％,in goserelin + DDP group was (62.4 ± 4.1 ) ％,in cetrorelix group was (71.2 ± 7.4) ％,and in cetrorelix + DDP group was (63.8 ±3.1 )％,in which they were much higher than that in DDP group ( 47.0 ± 4.8 ) ％ ( P ＜ 0.05 ).The level of AMH in goserelin group was ( 98 ± 27 ) ng/ml,which was much higher than that in NS group (66.2 ± 17.4) ng/ml (P ＜0.05),while there were no difference in the levelsof FSH,E2 or P among different groups ( P ＞ 0.05).Conclusion GnRH analogues could inhibit the growth of transplanted tumors in nude mice,meanwhile increase the secretion of AMH,decrease the frequencies and prolong the lasting time of estrus,decrease the ratio of atretic follicles,raise the ratio of primary and preantral follicles,which may be protect the ovarian function of nude mice.

Objective To investigate the resistance mechanisms and epidemiology of Enterobacteriaceae isolated from clinical with reduced susceptibility to imipenem or meropenem.Methods 18 strains of Enterobacteriaceae with reduced carbapenem susceptibility were collected during January to August in 2010.The MICs of these strains were determined using automated microbial identification system.ESBLs,AmpC and KPC were tested using the agar dilution method.PCR amplification and DNA sequence were performed to analyze the KPC genes,PFGE was used to examine the molecular epidemiology.Results All 18 strains were detected ESBLs and AmpC,14 strains were detected KPC-2.3 strains with EDTA paper method positive may produce other metal carbapenem,in which 2 strains harbor KPC-2.PFGE types indicate that there were six genotypes among 15 strains of Klebsiella pneumoniae.Conclusion Plasmid-mediated KPC-2 was the main reason which makes Enterobacteriaceae reducing carbapenem susceptibility and causes short-term epidemic in hospital.Clinical strains harboring KPC-2 gene may carry multiple resistance genes meanwhile.