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 optimize the honey processing technology of Phellinus igniarius. METHODS The key factors of honey processing technology of P. igniarius （honey-water ratio， the mass ratio of honey-water to P. igniarius， the frying temperature and the frying time） were investigated by orthogonal test combined with analytic hierarchy process to determine the optimal technological parameters， using the internal quality （the contents of ergosterol， protocatechuic aldehyde and protocatechuic acid） and appearance traits as evaluation indexes. RESULTS The optimal process of honey-roasting P. igniarius was to take raw P. igniarius （1 cm3 square block）， add the appropriate amount of auxiliary materials （with 25 kg of refined honey and water for every 100 kg of P. igniarius）， mix well， moisten for 2 h until the auxiliary materials were completely absorbed； put it in a frying container， fry at the frying temperature of 130-140 ℃ for 5 min； take it out， put it in an oven at 50 ℃ for 2 h； take it out， and let it cool. The RSD of the results of three validation experiments was 0.68%. CONCLUSIONS The optimized honey processing technology of P. igniarius is stable and feasible.

OBJECTIVE To optimize the honey processing technology of Phellinus igniarius. METHODS The key factors of honey processing technology of P. igniarius （honey-water ratio， the mass ratio of honey-water to P. igniarius， the frying temperature and the frying time） were investigated by orthogonal test combined with analytic hierarchy process to determine the optimal technological parameters， using the internal quality （the contents of ergosterol， protocatechuic aldehyde and protocatechuic acid） and appearance traits as evaluation indexes. RESULTS The optimal process of honey-roasting P. igniarius was to take raw P. igniarius （1 cm3 square block）， add the appropriate amount of auxiliary materials （with 25 kg of refined honey and water for every 100 kg of P. igniarius）， mix well， moisten for 2 h until the auxiliary materials were completely absorbed； put it in a frying container， fry at the frying temperature of 130-140 ℃ for 5 min； take it out， put it in an oven at 50 ℃ for 2 h； take it out， and let it cool. The RSD of the results of three validation experiments was 0.68%. CONCLUSIONS The optimized honey processing technology of P. igniarius is stable and feasible.

Objective:To investigate the risk factors of pathological complete response(pCR)after neoadjuvant therapy for locally advanced gastric cancer(LAGC)and assess the value of gastric tumor markers for predicting pCR in LAGC patients.Methods:We retrospectively ana-lyzed the clinical and pathological characteristics of 213 patients who underwent radical gastrectomy and gastric tumor marker analysis after neoadjuvant therapy at The Chinse PLA General Hospital First Medical Center,between January 2020 and April 2024(20 and 193 cases in the pCR and non-pCR groups,respectively).The interrelationships among pCR,tumor markers,and clinicopathological features were compared,and independent risk factors for pCR were analyzed.A nomogram was constructed to predict the pCR.Results:Among 213 patients,20(9.4% )achieved pCR.Univariate analysis showed that age(P=0.067),tumor bed diameter(P<0.001),gastrin-17 levels(P=0.005),CA72-4 levels(P=0.073),pepsinogen ratio(P=0.024),and neoadjuvant immunotherapy(P=0.022)were strongly associated with pCR in LAGC pa-tients.Multivariate analysis showed that neoadjuvant immunotherapy,CA72-4 levels<2.5 U/mL,gastrin-17 levels<1.48 pmol/L,and tumor bed diameter<2.85 cm were independent predictive factors for pCR in LAGC patients(P<0.05).These indicators were incorporated into a nomogram prediction model;an receiver operating characteristic curve(ROC)was plotted with an AUC(95% CI)of 0.863(0.785-0.942).The calibration and decision curves suggested that the nomogram was well calibrated and had a good net benefit.Conclusions:Gastric tumor markers can effectively predict pCR after neoadjuvant therapy in LAGC patients.Our nomogram showed a good predictive ability for pCR.Thus,our findings can serve as a useful reference for clinical decision making for LAGC patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To explore the regulatory effect of miR-204-5p on biological behaviors of bladder cancer cells and its molecular mechanism.Methods Survival analysis and correlation analysis were performed using TCGA database to explore the association of miR-204-5p expression with survival outcomes and clinicopathological parameters of bladder cancer patients.The expression level of miR-204-5p was detected in bladder cancer and adjacent tissues and in normal uroepithelial cells and bladder cancer cells.In cultured bladder cancer cells,the effects of miR-204-5p overexpression and knockdown on cell proliferation,migration,invasion,and apoptosis were analyzed.Transcriptome sequencing,bioinformatics analysis and dual-luciferase assay were carried out to confirm targeted inhibition of RAB22A by miR-204-5p to promote malignant biological behaviors of bladder cancer cells.Results Patients with high miR-204-5p expressions had lowered median survival time and poor prognosis(P<0.05).The expression of miR-204-5p was significantly up-regulated in bladder cancer tissues and cells(P<0.05).In bladder cancer cells,miR-204-5p overexpression significantly promoted cell proliferation,migration and invasion and reduced cell apoptosis.Transcriptome sequencing,bioinformatics analysis and dual-luciferase assay all suggested that RAB22A was a key downstream factor of miR-204-5p.Overexpression of miR-204-5p significantly inhibited RAB22A expression in bladder cancer cells,and overexpression of RAB22A partially reversed miR-204-5p overexpression-induced enhancement of bladder cancer cell proliferation.Conclusion High expression of miR-204-5p promotes proliferation,migration and invasion and reduces apoptosis of bladder cancer cells by negatively regulating RAB22A expression.

Kirsten rat sarcoma viral oncogene homolog(KRAS)is a type of gene closely related to human tumors.And it's an important medical index to access the tumor development,prognosis and the efficacy of chemoradiotherapy.RAS mutations,in which KRAS mutations account for up to 85%,are the most common oncogenic driving mutations in human tumors.The most frequent KRAS mutation sites are codons 12,13,61 and 146.Codon G12,as the most frequently mutated one,can be divided into multiple subtypes,with G12D mutation being the most common,followed by G12V,G12C,etc.Colorectal cancer(CRC)is one of the tumors with the highest frequency of KRAS mutations.Both G12D and G12V are the most common mutation subtypes in CRC.In the field of treatments for CRC with KRAS mutations,targeted therapy had not been possible until the release of KRASG12C inhibitors in 2013,and new drugs have been developed one after another since then.This study summarized the mutations of KRAS and the advances in clinical research,including the latest advances in targeted drugs,chemotherapy drugs,immunotherapy drugs,ferroptosis,and other treatment methods.Among them,in terms of targeted drugs,this review explored KRASG12C inhibitors(sotorasib,adagrasib,D-1553,IBI351,etc.),anti-angiogenic drugs(monoclonal antibodies such as bevacizumab,remdesizumab,etc),small molecule multi-target tyrosine kinase inhibitors such as sunitinib,etc.In terms of immunotherapy drugs,there have also been many advances,such as the ARETHUSA clinical trial,which found that temozolomide reduced the tumor mutational burden(TMB)of O-6-methylguanine-DNA methyltransferase(MGMT)deficiency and RAS mutation in patients with advanced metastatic colorectal cancer(mCRC),providing innovative ideas for patient immunotherapy.For example,the combination of xindilimab with bevacizumab,oxaliplatin,and capecitabine can be used for first-line treatment of RAS mutations,microsatellite stability(MSS),and unresectable mCRC.Relevant studies have shown that the combination therapy has good therapeutic potential and controllable tolerability safety.This review explored the mechanisms of KRAS mutations and the latest advances in clinical research and treatment,in order to provide reference for the treatment of KRAS mutated colorectal cancer.

Objective:To introduce the method of using anal fistula endoscope to treat chronic sinus tract leakage at rectal anastomosis site.Methods:We used anal fistula endoscopy to treat a patient with chronic sinus tract leakage after radical resection of rectal cancer, mainly including the following 5 steps: (1) establishing a water injection circulation system through the anus; (2) scraping off purulent coating and mucosa on the surface of the sinus tract with the brush; (3) hemostasis and removal of necrotic tissue with electrocoagulation rods; (4) filling the sinus tract with bioprotein gel; (5) compressing the sinus tract with transanal drainage tube.Results:The patient is a 70 year old male with rectal cancer. After undergoing 3D laparoscopic assisted radical resection of rectal cancer via abdominal anterior resection (Dixon's procedure) and diverting ileostomy surgery for more than 3 months, leakage of the rectal anastomosis was found through colonoscopy and anal iodine water contrast imaging .The patient started eating and flowing juice 6 hours after surgery, got out of bed 24 hours after surgery, and was discharged 48 hours after the removal of the anal canal. Three months after surgery, colonoscopy and transanal iodine hydrography showed that the sinus repair was intact. The diverting ileostomy was reduced 4 months after surgery.Conclusion:Anal fistula endoscope is safe and feasible for the treatment of chronic sinus tract anastomotic leakage in selected patients.

Objective:To introduce the method of using anal fistula endoscope to treat chronic sinus tract leakage at rectal anastomosis site.Methods:We used anal fistula endoscopy to treat a patient with chronic sinus tract leakage after radical resection of rectal cancer, mainly including the following 5 steps: (1) establishing a water injection circulation system through the anus; (2) scraping off purulent coating and mucosa on the surface of the sinus tract with the brush; (3) hemostasis and removal of necrotic tissue with electrocoagulation rods; (4) filling the sinus tract with bioprotein gel; (5) compressing the sinus tract with transanal drainage tube.Results:The patient is a 70 year old male with rectal cancer. After undergoing 3D laparoscopic assisted radical resection of rectal cancer via abdominal anterior resection (Dixon's procedure) and diverting ileostomy surgery for more than 3 months, leakage of the rectal anastomosis was found through colonoscopy and anal iodine water contrast imaging .The patient started eating and flowing juice 6 hours after surgery, got out of bed 24 hours after surgery, and was discharged 48 hours after the removal of the anal canal. Three months after surgery, colonoscopy and transanal iodine hydrography showed that the sinus repair was intact. The diverting ileostomy was reduced 4 months after surgery.Conclusion:Anal fistula endoscope is safe and feasible for the treatment of chronic sinus tract anastomotic leakage in selected patients.

Objective To explore the regulatory effect of miR-204-5p on biological behaviors of bladder cancer cells and its molecular mechanism.Methods Survival analysis and correlation analysis were performed using TCGA database to explore the association of miR-204-5p expression with survival outcomes and clinicopathological parameters of bladder cancer patients.The expression level of miR-204-5p was detected in bladder cancer and adjacent tissues and in normal uroepithelial cells and bladder cancer cells.In cultured bladder cancer cells,the effects of miR-204-5p overexpression and knockdown on cell proliferation,migration,invasion,and apoptosis were analyzed.Transcriptome sequencing,bioinformatics analysis and dual-luciferase assay were carried out to confirm targeted inhibition of RAB22A by miR-204-5p to promote malignant biological behaviors of bladder cancer cells.Results Patients with high miR-204-5p expressions had lowered median survival time and poor prognosis(P<0.05).The expression of miR-204-5p was significantly up-regulated in bladder cancer tissues and cells(P<0.05).In bladder cancer cells,miR-204-5p overexpression significantly promoted cell proliferation,migration and invasion and reduced cell apoptosis.Transcriptome sequencing,bioinformatics analysis and dual-luciferase assay all suggested that RAB22A was a key downstream factor of miR-204-5p.Overexpression of miR-204-5p significantly inhibited RAB22A expression in bladder cancer cells,and overexpression of RAB22A partially reversed miR-204-5p overexpression-induced enhancement of bladder cancer cell proliferation.Conclusion High expression of miR-204-5p promotes proliferation,migration and invasion and reduces apoptosis of bladder cancer cells by negatively regulating RAB22A expression.