Objective:To explore the impact of PM 2.5 concentration in Shanghai on the incidence of allergic rhinitis（AR） in the population, and provide strategies for early warning and prevention of AR. Methods:Collect daily average concentrations of atmospheric pollutants monitored in Shanghai from January 1, 2017 to December 31, 2019, and clinical data of AR patients from five hospitals in Shanghai during the same period. We used a time-series analysis additive Poisson regression model to analyze the correlation between PM 2.5 levels and outpatient attendance for AR patients. Results:During the study period, a total of 56 500 AR patients were included, and the daily average concentration of PM 2.5 was（35.28±23.07）μg/m³. There is a correlation between the concentration of PM 2.5 and the number of outpatient attendance for AR cases. There is a positive correlation between the daily average number of outpatient for AR and levels of PM 2.5 air pollution（（P<0.05）） . We found that every 10 μg/m³ increase in PM 2.5, the impact of on the number of AR visits was statistically significant on the same day, the first day behind, and the second day behind, with the strongest impact being the exposure on the same day. Every 10 μg/m³ increases in PM 2.5, the number of outpatient visits increased by 0.526% on the same day（95%CI 1.000 50-1.010 04）. Conclusion:The atmospheric PM 2.5 concentration in Shanghai is positively correlated with the number of outpatient for AR, and PM 2.5 exposure is an independent factor in the onset of AR. This provides an important theoretical basis for AR.
Humans ; Particulate Matter/analysis* ; Air Pollutants/adverse effects* ; Incidence ; China/epidemiology* ; Air Pollution/adverse effects* ; Rhinitis, Allergic/etiology*

Objective The benefit of short-term dual antiplatelet therapy (DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap, we did a meta-analysis to assess the efficacy of ≤6 months versus ≥12 months DAPT among patients with second-generation drug-eluting stents.Methods We searched online databases and identified randomized controlled trials that assess the clinical impact of short-term DAPT (≤6 months) published before March 3, 2016. The efficacy endpoints included the incidence of all-cause death, myocardial infarction, cerebrovascular accidents, and definite or probable stent thrombosis. Safety endpoint defined as major bleeding was also evaluated and discussed.Results We included 5 trials that randomized 9473 participants (49.8%, short-term DAPT duration vs. 50.2%, standard duration). A total of 9445 (99.7%) patients reported the efficacy endpoints, and the safety endpoint was available from 4 studies (n=8457). There was no significant difference in efficacy endpoints between short-term and standard DAPT duration (≥12 months) [risk ratio (RR) 0.96; 95% confidence intervals (CI), 0.80-1.15]. Short-term DAPT duration did not significantly increase the individual risk of all-cause death, myocardial infarction, cerebrovascular accidents, or definite or probable stent thrombosis. Although short-term DAPT obviously reduced risk of major bleeding compared with standard DAPT (RR 0.53; 95% CI, 0.29-0.96), significant publication bias was found when accessing the safety endpoint of the 4 studies (Egger's test, P=0.009).Conclusions The efficacy of short-term DAPT was comparable with that of standard duration DAPT. DAPT less than 6 months may be appropriate for patients receiving second-generation drug-eluting stents implantation.
Drug-Eluting Stents ; Humans ; Myocardial Infarction ; chemically induced ; Platelet Aggregation Inhibitors ; adverse effects ; therapeutic use ; Randomized Controlled Trials as Topic ; Stroke ; chemically induced ; Thrombosis ; chemically induced ; Time Factors

OBJECTIVETo explore the related factors of optical coherence tomography (OCT) detected in-stent heterogeneous neointimal in coronary stents.

METHODSA total of 143 cases of coronary heart disease patients with OCT detected in-stent neointimal hyperplasia in Fuwai hospital from September 2009 to April 2012 were included in this study and patients data were retrospectively analyzed. Patients were divided into heterogeneous intima group(26 cases) and homogeneous intima group(117 cases)according to neointimal characteristics. Clinical features and OCT characteristics of the 2 groups were compared and binary logistic regression analysis was performed to analyze the risk factors of in-stent heterogonous neointimal hyperplasia.

RESULTSCompared to homogeneous intima group, patients in heterogeneous intima group had significantly higher cholesterol level ((5.31±1.11)mmol/L vs.(4.70±0.94)mmol/L, P=0.005), low-density lipoprotein cholesterol level ((2.57±0.87)mmol/L vs.(2.29±0.46)mmol/L, P=0.021) and triglyceride level (2.12(1.82-2.87)mmol/L vs. 1.90(1.73-2.11)mmol/L, P=0.015). Moreover, the percent of percutaneous coronary intervention (PCI) because of acute coronary syndrome (23.1%(6/26) vs. 6.8%(8/117), P=0.022) and the thin cap neoatheroma (5.8%(28/481)vs. 3.9%(89/2 276), P=0.043) were also significantly higher in heterogeneous intima group than in homogeneous intima group. Binary logistic regression analysis showed that low-density lipoprotein cholesterol (OR=2.74, 95%CI 1.04-7.24, P=0.042), triglyceride (OR=2.88, 95%CI 1.05-7.89, P=0.040), PCI for acute coronary syndrome (OR=12.74, 95%CI 2.69-60.49, P=0.001), and cerebrovascular disease (OR=13.09, 95%CI 2.16-79.53, P=0.005) were risk factors for in-stent heterogenous intima. Time post stent implantation was protective factor for in-stent heterogenous intima (OR=0.63, 95%CI 0.42-0.96, P=0.033).

CONCLUSIONOCT detected heterogeneous intima is correlated with level of blood lipid, PCI for acute coronary syndrome and history of cerebrovascular disease, and it may lead to unstable intima.

Acute Coronary Syndrome ; Coronary Artery Disease ; Humans ; Hyperplasia ; Neointima ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Stents ; Tomography, Optical Coherence ; Tunica Intima

In the article we described a case of 61-year-old male with pharyngeal paraesthesia for 3 months. Physical examination: lean physique; vast uneven white membrane above hard palate, soft palate and pharynx mucous membrane, not easy to wipe and extend to the throat. The neck without cervical lymph node enlargement. Blood routine test: WBC 4.92 x 10(9)/L, N 64.3%, L 18.7%, EO 7.1%. RBC 4.08 x 10(12)/L, PLT 181 x 10(9)/L. No significant abnormal in the other blood biochemical indexes, tumor marker and immune indexes; blood bacteria culture: negative; blood culture: negative; sputum culture (3 times): all negative; anti-HIV screening test: positive, serum HIV testing: positive(the test done by Shanghai Pudong new area's centers for disease control and detection). The incidence of HIV/AIDS is still low at present, so the diagnosis of HIV/AIDS can be ignored easily by the otolaryngology doctor. If the patient with oral cavity and pharyngeal ulcer delayed healing, the doctor should be alert to,HIV/AIDS infection. We should check serum HIV antibody to eliminate or confirm HIV/AIDS earlier.
HIV Infections ; diagnosis ; Humans ; Male ; Middle Aged ; Otolaryngology ; methods

Objective To construct the recombinant yeast expressing PreS2 120-146-hepatitis B surface antigen (HBsAg),and to evaluate the immune effects of whole yeast cells.Methods PreS2 120-146 and HBsAg gene sequence were optimized according to the yeast cell codon preference,and were recombined and cloned into pPIC3.5K yeast expression vector to construct pPIC3.5K/PreS2 120-146 plasmid.After digested and linearized by Bgk Ⅱ restriction enzyme,pPIC3.5K/PreS2 120-146-HBsAg recombinant plasmid was electrotransformed into GS115 strain to screen PreS2 120-146-HBsAg-recombinant Pichiapastoris .The expression of PreS2 120-146-HBsAg was identified by sodium doclecyl sulfate polyacrylamide gel electrophogesis (SDS-PAGE),Western blot and enzyme linked immunosorbent assay (ELISA)analysis. BALB/c mice were vaccinated by inactivated whole recombinant yeast cells expressing target protein. Specific antibodies to HBsAg were detected by ELISA.Cytotoxic T lymphocyte (CTL)response induced by interferon (IFN)-γ was detected by reverse transcription-polymerase chain reaction (RT-PCR)when immune spleen cells of mice were stimulated by CTL epitope on HBsAg.Independent sample t test was used. Results Data of PCR detection,restriction enzyme digestion and sequencing analysis showed that recombinant pPIC3.5K/PreS2 120-146-HBsAg plasmid was successfully constructed.SDS-PAGE,Western blot and ELISA verified the expression of PreS2 120-146-HBsAg in the lysate of the recombinant Pichiapastoris induced by methanol.Levels of specific anti-HBsAg IgG antibodies produced by inactivated yeast cells vaccinated mice were comparable to purified HBsAg immunization (t =0.946,P =0.381 ). Analysis of HBsAg-specific CTL responses revealed that the level of IFN-γwas significantly higher when the immune spleen cells of mice were stimulated by CTL epitope peptides on HBsAg (t =2.305 ,P =0.044).Conclusions PreS2 120-146-HBsAg target protein is successfully expressed by construction of recombinant Pichiapastoris . The specific humoral and cellular immune responses are induced by recombinant whole yeast cells vaccinated mice.

Objective This retrospective study is performed to analyze the epidemiological and clinical features of patients with infective endocarditis (IE) hospitalized in Fuwai Cardiovascular Hospital during the latest 7 years.Methods This retrospective study included a cohort of 368 infective endocarditis patients hospitalized in Fuwai Hospital form August 2005 to August 2012.Predisposing cardiac diseases,causative organisms,clinical features and outcomes were analyzed.Risk factors related to outcome including NYHA classes,causative organisms and complications,were evaluated.Results Among the IE patients,6.8％ (25/368) patients had rheumatic heart diseases 31.8％ (117/368) had congenital heart diseases,22.8％ (84/368) were post-PCI or operative endocarditis and IE developed in 14.1％ (52/368) patients without previous cardiac diseases.Blood culture positive rate was 46.2％ (170/368).Streptococci viridians [27.6％ (47/170)]were the most common causative organisms,followed by coagulase-negative staphylococci [15.9％ (27/170)].Fever and cardiac murmur were the most common clinical presentations.Congestive heart failure was the most common complication [87.8％ (323/368)].Systemic and pulmonary embolism occurred in 16.0％ patients,80.9％ IE was detected by echocardiography.In-hospital mortality rate was 6.7％,mostly due to refractory congestive heart failure and sepsis.Subgroup analysis showed that incidence of post-PCI or operative endocarditis was significantly higher in IE patients hospitalized after 2009 compared to IE patients hospitalized before 2009 (27.5％ vs.19.2％,P ＜ 0.05).Higher incidence of staphylococcal infection was evidenced in mechanical valves than in native valves(44.4％ vs.19.8％,P ＜ 0.05).Conclusion During the past decade,there is a significant change on epidemiology and clinical features of IE in China.Incidence of post-surgical and interventional IE increased significantly.Staphylococcal and Gram negative bacilli infection are major pathorganisms of endocarditis of mechanical valves.Due to the lower positive rate of blood culture,echocardiography serves as the most important diagnostic tool for infective endocarditis.

OBJECTIVE: To investigate the correlation of polysomnography parameters and CT measurements in upper airway of mild and severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients before and after uvulopalatopharyngoplasty (UPPP). METHOD: Having PSG detection and spiral computed tomograph scan for 30 mild and severe OSAHS patients both before and after UPPP operation, compare the morphology change of upper airway on CT measurements, use pearson correlation analysis to analysis the correlation between the minimum cross-sectional area, left and right diameter, anteroposterior diameter in upper airway and apnea hypopnea index (AHI). RESULT: The difference of the minimum cross-sectional area, left and right diameter, anteroposterior diameter in upper airway before and after UPPP operation was significant. The minimum cross-sectional area, left and right diameter was negatively correlated with AHI; Left and right diameter was not correlated with AHI. CONCLUSION The minimum cross-sectional area, left and right diameter, anteroposterior diameter after operation is bigger than before operation. The minimum cross-sectional area, left and right diameter is negatively correlated with AHI.
Adult ; Female ; Humans ; Intraoperative Period ; Male ; Middle Aged ; Palate ; surgery ; Pharynx ; surgery ; Polysomnography ; Sleep Apnea, Obstructive ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Uvula ; surgery

Objective To investigate the intra- and interobserver repeatability of coronary artery disease (CAD) diagnosis based on invasive coronary angiography (ICA) and CT coronary angiography (CTCA).Methods Two readers with comparable experience ( over 10 years) independently evaluated ICA results of 42 consecutive patients with a blind method. After 30 days,one of them reviewed the same patients again.Another two comparable-experience (over 10 years) readers evaluated the results of CTCA (prospectively ECG-triggering) from the same 42 patients in the same way.The inter-reader and intra-reader repeatability of ICA and CTCA were analyzed by performing Kappa test and calculating the percentage of the segments with agreement on stenotic degree.Using ICA as reference,the accuracy of CTCA in diagnosing CAD was studied by comparing the area under ROC. Results The Kappa between readers for ICA and CTCA were 0.91 and 0.81.Intra-reader Kappa were 0.92 and 0.83 respectively (x2 =509.4 and 432.5,all P ＜0.01 ).The percentage of the segments with agreement between readers on the degree of stenosis were 80.8％ (494/611) in ICA and 75.2％ (469/624) in CTCA ( x2 =2.75,P =0.10),and within the same reader,86.9％ (531/611)in ICA and 81.9％ (511/624) in CTCA(x2 =3.76,P =0.053).With≥ 50％narrowing as a CAD diagnosis criterion,the agreement rates for two readers were 96.6％ (590/611 ) in ICA and 94.4％ (589/624) in CTCA( x2 =3.36,P =0.07),and for the same reader,97.4％ (595/611) in ICA,95.4％ (595/624) in CTCA ( x2 =3.62,P =0.06).Using ICA as reference,two readers of CTCA results achieved a sensitivity and specificity of 84.9％ (530/624)and 98.1％ (612/624).The area under ROC was 0.94 (95％ CI 0.91-0.97).Conclusions Both ICA and CTCA demonstrate good repeatability in diagnosing CAD.The repeatability of ICA is superior to that of CTCA.A certain discrepancy exists in two readings from the same reader or two readers.

OBJECTIVE: To investigate relationship between anti-endothelial cell antibody(AECA) and response to dexamethasone in sudden hearing loss(SHL). METHOD: Forty-eight SHL patients and thirty normal controls with SHL were recruited in present study. AECA was detected by ELISA in serum of all normal controls and SHL patients as well as pure-tone average was examined by electronic audiometry during treatment in SHL patients. Both AECA-positive and -negative subjects received 10 mg/d venous dexamethasone for 5 days followed by gradual tapering of dose of 5 mg/d for another 5-day. Then pure-tone average was reexamined. Differences in hearing recovery between AECA-positive and -negative subjects and relationship between AECA level and hearing recovery were analyzed. RESULT: The prevalence of AECA detection was 68.75% (33 of 48 patients) in SHL patients, with significant difference compared with control subjects with 23.33% (7 of 30 controls) (P<0.01). After treatment, rates of response to dexamethasone in AECA-positive and -negative SHL patients were 81.8% (27 of 33 patients) and 33.3% (5 of 15 patients), respectively. Meanwhile, there was a significant difference in cure, excellent recovery, partly recovery and invalid between AECA-positive and -negative groups [21.2% (7/33), 33.3% (11/33), 27.3% (9/33) and 18.2% (6/33) versus 0, 13.3% (2/15), 20.0% (3/15) and 66.7% (10/15), P<0.01]. Except 5 subjects with AECA level more than 263 microg/L, hearing recovery was correlated to pretreatment AECA level (r=0.8084, P<0.01). CONCLUSION In sudden HL patients treated with dexamethasone, AECA might represent a serological marker of prognosis.
Adolescent ; Adult ; Aged ; Audiometry, Pure-Tone ; Autoantibodies ; blood ; Case-Control Studies ; Child ; Dexamethasone ; therapeutic use ; Female ; Hearing Loss, Sudden ; blood ; drug therapy ; Humans ; Male ; Middle Aged ; Prognosis ; Young Adult

Objective To investigate the clinical value of ABCD score combined widl diffuse weighing imaging(DWI)for the estimation of transient ischemic attack(TIA)advancing to cerebral infarction in 7 days.Method The clinical dataincludingABCD score and DWI of 105 cases with TIA were analyzed.Results None of TIA patients with ABCD scores＜3 advanced to cerebral infarction.There were 83 cases with ABCD scores≥3,among whom 24 cases(28.9%)advanced to cerebral infarction.The higher ABCD scores,the higher incidence of cerebral infarction(P＜0.01).Nine of 42 cases(21-4%)with DWI abnrmal advanced to cerebral infarction,while 2 of 50 cases(4.0%)with normal DWI advanced to cerebml infarction (P＜0.05).Conclusion ABCD score is alleffective method for the estimation of TIA advancing to cerebral infarction,and when combined with DWI it is more efficient