Allergen-specific immunotherapy（AIT） remains the only therapeutic approach with the potential to modify the natural course of allergic rhinitis（AR）. Nevertheless, considerable inter-individual variability exists in patients'responses to AIT. To facilitate more reliable assessment of treatment efficacy, the China Rhinopathy Research Cooperation Group（CRRCG） convened young and middle-aged nasal experts in China to formulate the present consensus. The recommended subjective outcome measures for AIT comprise symptom scores, medication scores, combined symptom and medication scores, quality-of-life assessments, evaluation of disease control, and assessment of comorbidities. Objective indicators may supplement these measures. Currently available objective approaches include skin prick testing, nasal provocation testing, and allergen exposure chambers. However, these methods remain constrained by practical limitations and are not yet appropriate for routine implementation in clinical efficacy evaluation. In addition, several biomarkers, including sIgE and the sIgE/tIgE ratio, sIgG4, serum IgE-blocking activity, IgA, cytokines and chemokines, as well as immune cell surface molecules and their functional activity, have been shown to have associations with AIT outcomes. While these biomarkers may complement subjective assessments, they are subject to significant limitations. Consequently, large-scale multicenter trials and real-world evidence are required to strengthen the evidence base. The present consensus underscores the necessity of integrating patients'subjective experiences with objective testing throughout the treatment process, thereby providing a more comprehensive and accurate framework for efficacy evaluation. Looking forward, future investigations should prioritize the incorporation of multi-omics data and artificial intelligence methodologies, which hold promise for overcoming current limitations in assessment strategies and for advancing both the standardization and personalization of AIT.
Humans ; Allergens/immunology* ; China ; Consensus ; Desensitization, Immunologic ; Immunoglobulin E ; Quality of Life ; Rhinitis, Allergic/therapy* ; Treatment Outcome ; East Asian People

Objective To explore the relationship between serum S100 calcium-binding protein(S100)A4,S100A12 and the infection type and prognosis of neonatal infectious pneumonia(NIP).Methods A total of 300 children with NIP admitted to the Neijiang Second People's Hospital from January 2021 to March 2024 were selected and divided into the bacterial infection group(214 cases)and the non-bacterial infection group(86 cases)according to the types of pathogenic bacteria.Another 150 healthy newborns in the same hospital during the same period were selected as the control group.The levels of serum S100A4 and S100A12 were de-tected by enzyme-linked immunosorbent assay.Pearson correlation analysis was conducted to examine the cor-relations between serum S100A4,S100A12 and procalcitonin(PCT),white blood cell count(WBC),albumin(Alb),and platelet count(PLT).The receiver operating characteristic(ROC)curve was used to evaluate the differential value of serum S100A4,S100A12,PCT,WBC,Alb,and PLT alone and in combination for NIP bac-terial infection.According to the prognosis,children with NIP were divided into the poor prognosis group(63 cases)and the good prognosis group(237 cases).Multivariate Logistic regression model was used to analyze the influencing factors of poor prognosis in children with NIP,and ROC curve was used to analyze the value of each factor in predicting poor prognosis in children with NIP.Results The levels of serum S100A4,S100A12,PCT,WBC,and PLT in the bacterial infection group were higher than those in the non-bacterial infection group and the control group,while Alb was lower than that in the non-bacterial infection group and the control group,the differences were statistically significant(P<0.05).Pearson correlation analysis showed that serum S100A4 and S100A12 in children with NIP were positively correlated with PCT,WBC and PLT(P<0.05),and negatively correlated with Alb(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of serum S100A4 and S100A12 in differentiating NIP infection types was slightly lower than that of PCT,WBC,Alb,and PLT in differentiating NIP infection types.The results of multivariate Logistic re-gression analysis showed that elevated S100A4,elevated S100A12,elevated PCT,bacterial infection,and lung consolidation were independent risk factors for poor prognosis in children with NIP(P<0.05).The AUC of bacterial infection,lung consolidation,PCT,S100A4,and S100A12 for predicting the poor prognosis of chil-dren with NIP was 0.903.It was greater than the AUC predicted separately by bacterial infection,lung consol-idation,PCT,S100A4,and S100A12 levels(Z=9.989,9.460,5.514,4.084,4.376,P<0.001).Conclusion The combination of serum S100A4 and S100A12 with traditional markers has certain discrimina-tory value for the infection types of NIP,and the levels of serum S100A4 and S100A12 are related to the prog-nosis of NIP.

Objective To discuss the efficacy of transcatheter arterial chemoembolization(TACE)in combination with targeted therapy and immune checkpoint inhibitors for advanced hepatocellular carcinoma(HCC),and to identify the influencing factors.Methods A total of 60 patients with advanced HCC,who were admitted to the Air Force Medical Center of China from January 2016 to December 2022,were enrolled in this study.Thirty patients received TACE combined with targeted therapy and immune checkpoint inhibitors(TACE-L-P group),and the other 30 patients received TACE combined with targeted therapy(TACE-L group).The progression-free survival(PFS),overall survival(OS),disease control rate(DCR),and objective response rate(ORR)were compared between the two groups.Results In the TACE-L group and TACE-L-P group,the median PFS(mPFS)was 7 months and 10 months respectively(P=0.011),the median OS(mOS)was 15.5 months and 29 months respectively(P=0.014).Child-Pugh class B(HR=3.89,95％CI:1.27-11.94,P=0.018)and Barcelona Clinic Liver Cancer(BCLC)stage C(HR=2.83,95％CI:1.32-6.03,P=0.007)were the independent risk factors for OS,while micro wave ablation(HR=0.21,95％CI:0.07-0.63,P=0.005)and TACE-L-P(HR=0.09,95％CI:0.03-0.3,P=0.001)were the independent protection factors for OS.Besides,elevated bilirubin level(HR=1.03,95％CI:1-1.06,P=0.032)and elevated gamma-glutamyl transferase(GGT)level(HR=1.01,95％CI:1-1.01,P=0.002)were the independent risk factors for disease progression,and TACE-L-P(HR=0.27,95％CI:0.09-0.79,P=0.017)was the independent protection factor for disease progression.The ORR and DCR in TACE-L-P group were remarkably higher than those in TACE-L group,which were 43.4％vs 13.3％and 63.4％vs 23.3％respectively,the differences between the two groups were statistically significant(both P＜0.05).Conclusion In treating advanced HCC,TACE combined with targeted therapy and immune checkpoint inhibitors is superior to TACE combined with targeted therapy in therapeutic efficacy.

It is still at the initial stage for basic-level military doctors to participate in the standardized residency training. While, their professional backgrounds and training objectives are significantly different from those civilian residents, it is necessary to explore the standardized training methods in line with the military career demands for those basic-level military doctors. Based on the actual needs of grass-roots troops and military medicine, this study makes significant progress in the integration of standardized residency training and field surgery training methods, making the basic-level military doctors achieve the goal of field surgery training in the course of clinical practice of residents. Not only the surgical capability of basic-level military doctors, but also the medical support capability in grass-roots troops has been improved. This article summarizes the application methods and experience of field surgery teaching in the standardized residency training of military medical residents at the grass-roots level.

Objective:To explore the risk factors and preventive strategies of pancreatitis after percutaneous transhepatic biliary drainage (PTBD) in patients with pancreatic cancer and obstructive jaundice.Methods:A total of 241 patients were retrospectively analyzed from May 2001 to October 2014 in Tianjin Medical University Cancer Institute and Hospital. The possibly correlated 9 factors were analyzed, including gender, age, hemoglobin level, total bilirubin level, degree of pancreatic duct dilatation, degree of pancreatic atrophy, degree of biliary stenosis, the pancreatic duct visualization, and drainage mode.Results:Univariate analysis suggested that pancreatic duct dilatation, pancreatic atrophy, visualized pancreatic duct and drainage mode were associated with the incidence of pancreatitis after PTBD ( P<0.05). Logistic regression analysis showed that visualization of pancreatic duct ( OR=6.33) was a risk factor for pancreatitis, while pancreatic duct dilatation ( OR=0.14), pancreatic atrophy ( OR=0.12) and external drainage ( OR=0.11) were protective factors for pancreatitis. Conclusion:In pateints with pancreatic cancer and obstructive jaundice, pancreatic duct dilatation and pancreatic atrophy predict low risk of pancreatitis after PTBD,while intraoperative pancreatic duct visualization and internal or external drainage may increase the incidence of postoperative pancreatitis.

Objective:To conduct theoretical analysis and experimental research on peripherally inserted venous catheters, establish theoretical models of interaction between different materials catheters and simulated skin tissues, and test different catheters at the same time to provide theoretical basis and experimental basis for the optimization design.Methods:According to the mechanical properties of the catheter at 25 ℃ and 37 ℃, a finite element model of the catheter and simulate skin tissue was established. The relationship between catheter folds and material and structure during puncture was analyzed, and the stiffness, radiographic properties, etc. were tested experimentally.Results:The performance of the catheter at different temperatures is closely related to its material. The wrinkle situation of the catheter is related to the catheter material and the inclination of the wedge surface. The elastic modulus of the polyurethane (PU) catheter is about 500 MPa and 250 MPa, respectively at room temperature (25 ℃) and body temperature (37 ℃), which meets the clinical needs of high rigidity during puncture and soft material during indwelling. When the catheter structure is the same, the PU catheter is less prone to wrinkles than the fluorinated ethylene propylene copolymer (FEP) catheter. When the catheter material is the same, the smaller the inclination of the wedge surface, the less likely the catheter to wrinkle.Conclusions:Appropriately reducing the inclination of the wedge-shaped surface of the needle of peripherally inserted venous catheters can improve the success rate of puncture. The PU catheters have good mechanical properties, they are not prone to wrinkles during puncture, and their stiffness can be reduced at body temperature, which can not only increase the success rate of puncture, but also reduce the occurrence of complications. Therefore, PU catheters have a better clinical application prospect.

Objective:To describe a systematic approach on identification of poisonous mushroom by investigating two cases of Omphalotus guepiniformis poisoning in Jianyang district, Nanping, Fujian province. Methods:Two incidents of food poisoning on 10 migrant workers were investigated. The remaining suspected mushroom samples were collected and the same fresh mushroom specimens were also collected in the following field investigations from the same dead tree and fallen trunk. These mushroom specimens were identified based on morphological and phylogenetic analyses.Results:On November 24 and 26, 2018, 8 and 2 migrant workers from Jianyang District, Nanping ate wild mushrooms and developed acute nausea, vomiting, abdominal pain and other symptoms within 10 to 90 min after consumption. They were diagnosed as mushroom poisoning, with gastroenteritis as the main manifestation. Further analysis showed that the more poisonous mushroom were consumed, the shorter latency and longer duration of nausea and vomiting were resulted. After admission, gastric lavage, catharsis, acid preparation, gastric protection, fluid replenishment and other symptomatic support treatments were given in time, all patients were discharged in 1-3 d. Based on morphological and phylogenetic analyses, the samples were identified as O. guepiniformis. Conclusions:The two incidents were caused by accidental consumption of O. guepiniformis. Awareness education about poisonous mushroom should be provided to migrant workers to prevent more such poisoning incidents in the future.

Objective:To evaluate the clinicopathological features of primary retroperitoneal paragangliomas.Methods:Data of 24 patients with retroperitoneal paragangliomas who underwent surgical treatment in our hospital from Jan 2015 to Dec 2018 was collected and analyzed.Results:Hypertension, abdominal pain/discomfort and headache were the most common complaints while 10 patients were asymptomatic and were diagnosed accidently in routine body examination. Tumor size ranged from 3.4-13.0 cm (6.9±2.5) cm, and all the tumors were located in the vicinity of abdominal aorta and inferior vena cava. All the patients received surgical treatment. Intraoperative blood pressure fluctuations were significantly correlated with prolonged operation time, more blood loss, more blood transfusion and prolonged length of stay (all P<0.05). The median follow-up time was 29 months and 1 patient died from tumor recurrence and progression. The other patients have had a tumor free survival. Conclusions:Surgical resection was the principal treatment of primary paraganglioma. Preoperative assessment was very important for perioperative safety.

Objective:To investigate the pathogeny, diagnosis and treatment of solitary fibrous tumors of the abdomen and pelvis.Methods:Retrospective analysis was made on the clinical data of 12 SFT patients undergoing surgical resection in Peking University International Hospital from Jul 2015 to Jul 2019.Results:All patients underwent radical resection. After operation, complications in clued pelvic hemorrhage in 1 case and ureteral fistula in 1 case, all improved after conservative treatment.According to pathological and immunohistochemical results, 7 cases were MSFT and 5 cases were SFT. All patients were followed up for 2-53 months. 5 cases were recurrent, among which 1 case died of intestinal obstruction caused by tumor compression.Conclusion:The clinical manifestations of solitary fibrous tumors are mostly nonspecific.Imaging examination and puncture pathology are of great significance for preoperative diagnosis. Radical resection is an important means to improve the prognosis of patients.

Objective To analyze the influence from size parameters of minimally invasive vascular clamp on mechanical properties of small arteries. Methods The finite element simulation analysis on the process of minimally invasive vascular clamp clamping small arteries was performed. The influence patterns of 5 different sawtooth spacing, sawtooth heights and sawtooth lengths on mechanical properties of small arteries were studied. Results Larger sawtooth spacing led to smaller maximum equivalent stress of the clamped artery. The maximum equivalent stress of the small artery was not linear with the sawtooth height of the vascular clamp. The maximum equivalent stress of the small artery was the smallest and the vascular injury was the minimal when the swatooth height was 75 μm. The sawtooth length of the vascular clamp had an important influence on mechanical properties of clamped small arteries. The maximum equivalent stress of the artery was proportional to the sawtooth length of the vascular clamp. Conclusions The size parameters of minimally invasive vascular clamp had an important influence on mechanical properties in the process of clamping small arteries. The research findings can provide guidance for the design of the minimally invasive vascular clamp.