This case report outlines the treatment of an 11-year-old female who underwent adenotonsillectomy six years ago for snoring but experienced postoperative inefficacy. Her symptoms worsened two weeks before readmission, with increased snoring and sleep apnea, disabling her from lying down to sleep. She was readmitted on December 1, 2023, and diagnosed with severe obstructive sleep apnea hypopnea syndrome and hypercapnia. Automatic BiPAP alleviated her symptoms, with sleep breathing parameters normalizing during treatment. Follow-up at one month showed significant acceleration in her growth and resolution of her hypersomnolence issue.
Humans ; Female ; Child ; Hypercapnia/complications* ; Sleep Apnea, Obstructive/complications* ; Positive-Pressure Respiration ; Noninvasive Ventilation

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:The primary goal of this study is to explore the safety and effectiveness of a new modified eversion carotid endarterectomy (MECEA).Methods:This is a retrospective case series study. One hundred patients were consecutively treated with MECEA by the same operator at Department of Vascular Surgery,Peking Union Medical College Hospital from January 2019 to December 2023. There were 77 males and 23 females. The age was (66.0±8.6)years (range: 39 to 85 years). Twenty-four (24.0%) patients were symptomatic with the degree of carotid stenosis over 50%,76 patients (76.0%) were asymptomatic with the degree of stenosis over 70%. All these patients meet the indication of carotid endarterectomy. The main difference between MECEA and traditional eversion carotid endarterectomy was the anterior,lateral,and posterior walls of the internal carotid artery were incised obliquely from the origin of the internal carotid artery toward the common carotid artery,leaving the wall of internal carotid artery intact at the bifurcation. The surgical process,cardiovascular and cerebrovascular complications and other surgical complications were recorded. The incidences of complications,restenosis of intraoperative target lesions and re-intervention were collected during follow-up.Results:All procedures were performed successfully under general anesthesia. The total operation time was (36.5±10.1)minutes (range: 22 to 65 minutes),and carotid clamping time was (15.0±6.3)minutes (range: 7 to 31 minutes). One patient (1.0%) occurred postoperative cerebrovascular accident,1 patient (1.0%) developed cerebral hyperperfusion syndrome (CHS),and another 1 patient (1.0%) suffered myocardial infarction. All these patients were recovered after medical treatment within a week. The follow-up time( M(IQR)) was 24 (28) months (range: 6 to 62 months). Two patients (2.0%) were reported to have hemodynamically significant restenosis within 2 years,with one patient requiring intervention. No patient suffered from ipsilateral ischemic stroke. Conclusions:MECEA is a safe and effective surgical method of treating carotid artery stenosis. This method can reduce carotid clamping time and lowers the risk of ischemic stroke. Meantime,it preserves the integrity of the adventitia at the bifurcation of carotid artery,reduces the chance of restenosis. Moreover,it might be helpful to prevent postoperative CHS due to reducing damage to the carotid body and carotid sinus nerve.

Objective:The primary goal of this study is to explore the safety and effectiveness of a new modified eversion carotid endarterectomy (MECEA).Methods:This is a retrospective case series study. One hundred patients were consecutively treated with MECEA by the same operator at Department of Vascular Surgery,Peking Union Medical College Hospital from January 2019 to December 2023. There were 77 males and 23 females. The age was (66.0±8.6)years (range: 39 to 85 years). Twenty-four (24.0%) patients were symptomatic with the degree of carotid stenosis over 50%,76 patients (76.0%) were asymptomatic with the degree of stenosis over 70%. All these patients meet the indication of carotid endarterectomy. The main difference between MECEA and traditional eversion carotid endarterectomy was the anterior,lateral,and posterior walls of the internal carotid artery were incised obliquely from the origin of the internal carotid artery toward the common carotid artery,leaving the wall of internal carotid artery intact at the bifurcation. The surgical process,cardiovascular and cerebrovascular complications and other surgical complications were recorded. The incidences of complications,restenosis of intraoperative target lesions and re-intervention were collected during follow-up.Results:All procedures were performed successfully under general anesthesia. The total operation time was (36.5±10.1)minutes (range: 22 to 65 minutes),and carotid clamping time was (15.0±6.3)minutes (range: 7 to 31 minutes). One patient (1.0%) occurred postoperative cerebrovascular accident,1 patient (1.0%) developed cerebral hyperperfusion syndrome (CHS),and another 1 patient (1.0%) suffered myocardial infarction. All these patients were recovered after medical treatment within a week. The follow-up time( M(IQR)) was 24 (28) months (range: 6 to 62 months). Two patients (2.0%) were reported to have hemodynamically significant restenosis within 2 years,with one patient requiring intervention. No patient suffered from ipsilateral ischemic stroke. Conclusions:MECEA is a safe and effective surgical method of treating carotid artery stenosis. This method can reduce carotid clamping time and lowers the risk of ischemic stroke. Meantime,it preserves the integrity of the adventitia at the bifurcation of carotid artery,reduces the chance of restenosis. Moreover,it might be helpful to prevent postoperative CHS due to reducing damage to the carotid body and carotid sinus nerve.

Objective:To investigate the clinical characteristics, diagnosis, treatment, and prognosis of primary thyroid lymphoma (PTL) .Methods:A retrospective analysis was conducted on the clinical and pathological data of 34 newly diagnosed PTL patients admitted to Beijing Tongren Hospital from September 2010 to February 2023. The Kaplan-Meier survival curve and Log-rank test were used for survival analysis, and the Cox regression model was applied for univariate analysis of prognostic factors.Results:All 34 PTL patients presented with cervical mass as the initial clinical manifestation. There were 9 males and 25 females. The pathological diagnosis was diffuse large B-cell lymphoma (DLBCL) in 29 patients and mucosa-associated lymphoid tissue (MALT) lymphoma in 5 patients. Among the DLBCL patients, 6 had B symptoms, 17 had an Eastern Cooperative Oncology Group (ECOG) score of ≥2, the Ann Arbor staging was stage Ⅰ-Ⅱ in 21 cases and stage Ⅲ-Ⅳ in 8 cases, the tumor diameter was ≥10 cm in 4 cases, and 14 had concurrent Hashimoto thyroiditis; 27 cases received chemotherapy, with 21 cases achieving complete remission (CR), 2 cases partial remission (PR), and 6 cases of disease progression; the 5-year progression-free survival and overall survival rates were 78.9% and 77.4%, respectively; univariate survival analysis showed that B symptoms, tumor diameter ≥10 cm, and Ann Arbor stage Ⅲ-Ⅳ were significant factors affecting patient prognosis ( P<0.05). MALT lymphoma patients were all in stages Ⅰ-Ⅱ, had an ECOG score of 0-1, and were without B symptoms. All patients underwent surgical resection, with 4 cases achieving CR and 1 case PR. Conclusion:PTL is more common in females with concurrent Hashimoto thyroiditis, with the majority of pathological types being B-cell lymphoma. The main treatment is chemotherapy, supplemented by radiotherapy and surgery, and the prognosis is relatively favorable.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

Objective:To explore whether there is Warburg effect in keloid fibroblasts (KFs) , hypertrophic scar fibroblasts (HSFs) and atrophic scar fibroblasts (ASFs).Methods:KFs, HSFs, ASFs and NFs were isolated and cultured, respectively, in vitro. Glucose consumption and lactate production of the cells in each group were tested and compared. The mRNA expression of key glycolytic enzymes was detected, including hexokinase 2 (HK2), fructose-2, 6-biphosphatase 3 (PFKFB3), pyruvate kinase isoform M 2 (PKM2) and lactate dehydrogenase A (LDHA). In addition, the effect of 2-deoxy-D-glucose(2-DG) on the proliferation of KFs and NFs were detected and compared.Results:Glucose consumption and lactate production in KFs were 45.5% and 38.1% higher than those in NFs respectively ( P<0.01), while there was no statistical difference in glucose consumption and lactate production between ASFs and NFs, HSFs and NFs ( P>0.05). The mRNA expression of HK2, PKM2 and LDHA genes in KFs were 4.7, 2.7 and 1.8 times higher than those in NFs ( P<0.05), respectively, while the gene expressions in ASFs and HSFs had no statistical differences from those in NFs ( P>0.05). Under the action of 2-DG, the cell proliferation activity in KF group and NF group were reduced by 37.5% and 27.0%, respectively, indicating that the inhibition effect of glycolysis inhibitor on the proliferation activity of KFs was significantly higher than that of NFs. Conclusions:There is Warburg effect in KFs and there are no similar phenomena in HSFs and ASFs.

Objective:To explore whether there is Warburg effect in keloid fibroblasts (KFs) , hypertrophic scar fibroblasts (HSFs) and atrophic scar fibroblasts (ASFs).Methods:KFs, HSFs, ASFs and NFs were isolated and cultured, respectively, in vitro. Glucose consumption and lactate production of the cells in each group were tested and compared. The mRNA expression of key glycolytic enzymes was detected, including hexokinase 2 (HK2), fructose-2, 6-biphosphatase 3 (PFKFB3), pyruvate kinase isoform M 2 (PKM2) and lactate dehydrogenase A (LDHA). In addition, the effect of 2-deoxy-D-glucose(2-DG) on the proliferation of KFs and NFs were detected and compared.Results:Glucose consumption and lactate production in KFs were 45.5% and 38.1% higher than those in NFs respectively ( P<0.01), while there was no statistical difference in glucose consumption and lactate production between ASFs and NFs, HSFs and NFs ( P>0.05). The mRNA expression of HK2, PKM2 and LDHA genes in KFs were 4.7, 2.7 and 1.8 times higher than those in NFs ( P<0.05), respectively, while the gene expressions in ASFs and HSFs had no statistical differences from those in NFs ( P>0.05). Under the action of 2-DG, the cell proliferation activity in KF group and NF group were reduced by 37.5% and 27.0%, respectively, indicating that the inhibition effect of glycolysis inhibitor on the proliferation activity of KFs was significantly higher than that of NFs. Conclusions:There is Warburg effect in KFs and there are no similar phenomena in HSFs and ASFs.

Objective To explore the effects of Tongyuan acupuncture combined with herbal medicine and moxibustion on the behavior and hypothalamic-pituitary-adrenal axis-related hormone levels in postpartum de-pression rats.To explore the therapeutic mechanism of this method in the treatment of postpartum depression.Meth-ods A total of 120 SD rats were randomly divided into 6 groups(n=20).The blank group was not treated.The sham operation group was performed without surgery to remove the ovaries. The model group,drug group,routine acupuncture group and experimental group were established in the model of postpartum depression.After modeling successfully,the model group did not interfere with any treatment. The rats in treatment group were treated with fluoxetine hydrochloride. The acupuncture group was treated with acupuncture of Baihui and Taichong. The rats in the experimental group were treated with the method of acupuncture and moxibustion.At the end of the second and fourth week after the initiation of intervention,10 rats were randomly selected from each group.They were sacrificed and the levels of serum corticotropin-releasing hormone(CRH),adrenocorticotropic hormone(ACTH),cortisol (Cor)were measured.Results The levels of CRH,ACTH and Cor in the model group were higher than those in the blank group(P<0.05).The levels of serum CRH,ACTH and Cor in the drug group,routine acupuncture group and experimental group were lower than those in the model group(P<0.05).The levels of serum ACTH and Cor in the experimental group were lower than those in the drug group and routine acupuncture group(P<0.05).There was no significant difference in serum CRH,ACTH and Cor level between the experimental group and blank group(P >0.05).Conclusions Tongyuan acupuncture combined with salt moxibustion and Shenque have significant effects on the depressive symptoms and serum levels of CRH,ACTH and Cor in postpartum depression rats,which may be re-lated to the regulation of hypothalamic-pituitary-adrenal axis-related hormone levels.

To investigate the mechanism of lead biosorption and biotransformation in lead-resistant bacteria in microcosmic scale, synchrotron radiation micro X-ray fluorescence (μ-SRXRF ) and X-ray absorption near edge structure ( XANES) was used to determine the element distribution characteristics and speciation of lead ( Pb) in lead-resistant bacteria strain isolated from farmland soil samples taken from a lead-zinc mine in Lanping county, Yunnan province in China. The isolated species was identified to be Arthrobacter sp. The concentration of Pb biosorpted in lead-resistant bacteria was directly determined byμ-SRXRF, and the results showed that the highest concentration was 5925μg/g and the bioaccumulate factor was 14 . 8 . Speciation of Pb in lead-resistant bacteria B2, LB ( Lysogeny Broth) medium and soil were also presented after using Pb LⅢXANES. Compared with Pb LⅢ XANES peak shape and peak position between standard samples, it was demonstrated that the Pb in lead-resistant bacteria was mainly formed by amorphous forms like PbS (58. 0%), (C17H35COO)2Pb (22. 2%), Pb5(PO4)3Cl (19. 8%) rather than organic Pb speciation which was exist in LB medium. Therefore, the isolated lead-resistant bacteria could biotransform Pb to sulfuric compounds. The biotransformation regular could be of great interest for other investigators as reference in study of bioavailability impact factor of heavy metals.