Objective To analyze the distribution of common allergens in children with allergic rhinitis(AR)in Hangzhou,and to provide reference for its prevention and treatment.Methods From January 2020 to December 2022,13 521 children who were diagnosed with AR and underwent in vitro serum specific immunoglobulin E(sIgE)detection in Affiliated Hangzhou First People's Hospital,School of Medicine,Westlake University were selected as the research objects.The positive rates of allergens in children with AR of different genders,ages and seasons were compared.Results Among 13 521 children,the positive rate of sIgE was 54.49%(7367/13 521),of which 64.82%were allergic to only one allergen.Among the 19 common allergens,the top three overall positive rates were household dust mite(44.27%),milk(14.62%),and mixed grass(4.82%).The positive rates of allergens of house dust mites,cat hair dander,mulberry,mold combination,tree pollen combination,amaranth,cockroach,milk,shrimp,crab,pineapple,shellfish and mango in male children were significantly higher than those in female children(P<0.05).The positive rates of allergens of house dust mite,mixed grass,cat hair dander,mulberry,mold combination,egg white,shrimp,crab,pineapple,cashew nuts and shellfish in different age groups were statistically significant(P<0.05).July and August were the two months with the highest allergen positive rate.The allergen positive rates of house dust mite,dog and cat hair dander were the highest in summer,and the allergen positive rate of plants was consistent with the flowering season.The sIgE concentration of house dust mite(77.87%)was mainly grade 3 and above.The sIgE concentration of other allergens was mainly grade 1 and 2.Conclusion Dust mites and milk are the most common allergens in children with AR in Hangzhou,and the distribution of allergens varies with gender,age and season.Allergen detection can provide a more accurate plan for the diagnosis,prevention and treatment of AR.

Objective To investigate the difference of CT features of gastrointestinal stromal tumors(GIST),neurogenic tumors,and leiomyomas in stomach.Methods A retrospective analysis was performed on clinical and CT features from 312 cases of GIST,21 cases of neurogenic tumors,and 35 cases of leiomyomas in stomach.Results GIST were most commonly found in the body of stomach and exhibited large tumor sizes and late onset.CT showed GIST predominantly showed intraluminal and mixed growth pattern with irregular or round shapes and uneven density,and cystic degeneration and calcification were frequently observed.The CT values of GIST in the arterial phase and the degree of arterial enhancement were higher,with light to moderate arterial phase enhancement and moderate to marked venous phase enhancement.Gastric leiomyomas had smaller tumor sizes and presented mainly in the cardia,gastric fundus,and lesser curvature of gastric body.CT showed the intraluminal growth pattern,primarily in round shapes with uniform density,lower incidence of cystic degeneration and calcification,both the arterial and venous phase CT values and the extent of enhancement in these phases were lower,showed no or slight enhancement during the arterial phase and light to moderate enhancement during the venous phase.Gastric neurogenic tumors were predominantly located in the gastric body and antrum.CT showed the tumors demonstrated extraluminal and mixed growth patterns,most with oval-shaped appearace,uniform density and the venous phase CT values and the degree of enhancement were higher,with light to moderate arterial enhancement and moderate to marked venous enhancement.Conclusion GIST,neurogenic tumors,and leiomyomas in stomach can be differentiated based on their distinct CT features.Accurate recognition of these features aids in the differential diagnosis of these kinds of tumors.

Polyphyllin Ⅰ(PPⅠ)and polyphyllin Ⅱ(PⅡ)are the main active substances in the Paris polyphylla.However,liver toxicity of these compounds has impeded their clinical application and the potential hepatotoxicity mechanisms remain to be elucidated.In this work,we found that PPⅠ and PⅡ exposure could induce significant hepatotoxicity in human liver cell line L-02 and zebrafish in a dose-dependent manner.The results of the proteomic analysis in L-02 cells and transcriptome in zebrafish indicated that the hepa-totoxicity of PPⅡ and PⅡwas associated with the cholesterol biosynthetic pathway disorders,which were alleviated by the cholesterol biosynthesis inhibitor lovastatin.Additionally,3-hydroxy-3-methy-lglutaryl CoA reductase(HMGCR)and squalene epoxidase(SQLE),the two rate-limiting enzymes in the choles-terol synthesis,selected as the potential targets,were confirmed by the molecular docking,the over-expression,and knockdown of HMGCR or SQLE with siRNA.Finally,the pull-down and surface plasmon resonance technology revealed that PPⅠ could directly bind with SQLE but not with HMGCR.Collectively,these data demonstrated that PPⅠ-induced hepatotoxicity resulted from the direct binding with SQLE protein and impaired the sterol-regulatory element binding protein 2/HMGCR/SQLE/lanosterol synthase pathways,thus disturbing the cholesterol biosynthesis pathway.The findings of this research can contribute to a better understanding of the key role of SQLE as a potential target in drug-induced hepatotoxicity and provide a therapeutic strategy for the prevention of drug toxic effects with similar structures in the future.

This study investigated the anti-angiogenic activities of two diarylheptanoids, together with a structure analogue, curcumin. The activity and toxicity of these three compounds were compared using transgenic zebrafish as in vivo model and human umbilical vein endothelial cell(HUVEC)as in vitro model. Anti-angiogenic index(AI)was used as the ratio between LC50 and EC50. The results suggested that in both in vitro and in vivo assay, curcumin exerted the most potent anti-angiogenic effect but with lowest toxicity among these compounds; Yakuchinone A was the second potent; Yakuchinone B has the lowest activity but with the highest toxicity in all three compounds. Taken together, curcumin was the best angiogenic inhibitor in these three diarylheptanoids.

Twelve compounds were isolated from the ethanol extract of Fructus Gleditsiae Abnormalis by macroporous resin, silica gel, Sephadex LH-20, MCI and ODS column chromatographies. Their structures were identified on the basis of physicochemical properties and spectral data as gleditsioside A(1), gleditsioside B(2), gleditsioside H(3), gleditsioside I(4), gleditsioside J(5), gleditsioside K(6), gleditsia saponins C′(7), tamarixetin-7-O-β-D-glucopyranoside(8), neohesperidin(9), chrysoeirol-7-O-neohesperidoside(10); syringaresinol- O-β-D-glucopyranoside(11), liriodendrin(12). Compounds 8-12 were firstly isolated from this genus.

Twelve compounds were isolated and purified from ethyl acetatefraction of Cynanchum stauntonii by silica gel, Sephadex LH-20 and ODS column chromatography. Their structures were identified by spectral techniques and physicochemical properties as syringaresinol(1), (-)-(7R, 7′R, 7″R, 8S, 8′S, 8″S)-4′, 4″-dihydroxy-3, 3′, 3″, 5-tetramethoxy-7, 9′ ∶7′, 9-diepoxy-4, 8″-oxy-8, 8′-sesquineolignan-7″, 9″-diol(2), prinsepiol(3), 4-hydroxyacetophenone(4), baishouwubenzophenone(5), 2, 4-dihydroxyacetophenone(6), benzoic acid(7), 1, 4-benzenediol(8), 6-O-［E］-sinapoyl-α-D-glucopyranoside(9a), 6-O-［E］-sinapoyl-β-D-glucopyranoside(9b), 1-O-methyl-α-D-cymadropyranoside(10), β-daucosterol(11), and β-sitosterol(12). Compounds 1-3, 5 and 7-11 were firstly isolated from this plant.

OBJECTIVETo study the clinicopathological and immunohistochemical features, histogenesis and prognosis of pleuropulmonary blastoma (PPB) in children.

METHODSPPB specimens from 16 pediatric cases with an age ranging from 1 year and 7 months to 5 years and 3 months (mean age of 3 years) were retrieved and analyzed by routine histological, immunohistochemical and electron methods.

RESULTSAmong 16 patients, there were 2 type I, 7 type II and 7 type III PPB cases. Type I PPB as multilocular cystic structure, consisted of thin fibrous wall lining the respiratory epithelium, subepithelial primitive blastema or immature mesenchymal cells, with or without rhabdomyoblastic differentiation or cartilage; Type II PPB as cystic-solid tumor, comparing with type I, consisted of intracystic components with appearance of anaplastic tumor cells. Type III PPB consisted of completely solid mass, the same as the solid region of type II, had mixed pattern including blastema, undifferentiated spindle-cell proliferations and sarcomas. In addition, anaplastic tumor cells and intra-and extra- cytoplasmic eosinophilic globules were also commonly present. Epithelial components in PPB were benign. Immunohistochemical study showed primitive mesenchymal differentiation of tumors. All cases were positive for vimentin, desmin, myogenin and SMA in tumors with skeletal muscle differentiation, S-100 was positive in tumors with cartilage differentiation. All tumors were negative for synaptophysin, CD99, and CD117. Benign epithelial components were positive for AE1/AE3 and EMA. In 12 cases, electron microscopy revealed few organelles in the primitive mesenchymal cells and rich heterochromatin in mesenchymal cells, the latter also demonstrating cytoplasmic myofilament dysplasia. Nine cases had clinical follow-up ranging from 5 to 48 months, of which 4 patients died.

CONCLUSIONSPPB is a rare lung neoplasm of children under the age of 6 years, with distinct pathological morphology. PPB may arise from lung or pleura mesenchymal cells and has a poor clinical outcome.

Child, Preschool ; Cysts ; pathology ; Desmin ; analysis ; Female ; Humans ; Infant ; Lung Neoplasms ; chemistry ; pathology ; Male ; Microscopy, Electron ; Myogenin ; analysis ; Prognosis ; Pulmonary Blastoma ; chemistry ; pathology ; Sarcoma ; pathology ; Vimentin ; analysis

Objective To study the clinicopathological and immunohistochemical features , histogenesis and prognosis of pleuropulmonary blastoma ( PPB) in children.Methods PPB specimens from 16 pediatric cases with an age ranging from 1 year and 7 months to 5 years and 3 months ( mean age of 3 years) were retrieved and analyzed by routine histological , immunohistochemical and electron methods.Results Among 16 patients, there were 2 type Ⅰ, 7 type Ⅱ and 7 type Ⅲ PPB cases.Type Ⅰ PPB as multilocular cystic structure , consisted of thin fibrous wall lining the respiratory epithelium , subepithelial primitive blastema or immature mesenchymal cells , with or without rhabdomyoblastic differentiation or cartilage;Type Ⅱ PPB as cystic-solid tumor,comparing with type Ⅰ, consisted of intracystic components with appearance of anaplastic tumor cells.TypeⅢPPB consisted of completely solid mass , the same as the solid region of type Ⅱ, had mixed pattern including blastema ,undifferentiated spindle-cell proliferations and sarcomas.In addition, anaplastic tumor cells and intra-and extra-cytoplasmic eosinophilic globules were also commonly present.Epithelial components in PPB were benign.Immunohistochemical study showed primitive mesenchymal differentiation of tumors.All cases were positive for vimentin , desmin, myogenin and SMA in tumors with skeletal muscle differentiation , S-100 was positive in tumors with cartilage differentiation.All tumors were negative for synaptophysin ,CD99,and CD117.Benign epithelial components were positive for AE1/AE3 and EMA.In 12 cases, electron microscopy revealed few organelles in the primitive mesenchymal cells and rich heterochromatin in mesenchymal cells , the latter also demonstrating cytoplasmic myofilament dysplasia.Nine cases had clinical follow-up ranging from 5 to 48 months, of which 4 patients died.Conclusions PPB is a rare lung neoplasm of children under the age of 6 years,with distinct pathological morphology .PPB may arise from lung or pleura mesenchymal cells and has a poor clinical outcome.

Objective To explore the application and effect of case-based learning(CBL)in vas-cular surgery clinical teaching. Methods Totally 37 resident doctors were randomly divided into 2 groups respectively: CBL teaching group (n=21)and traditional teaching group (n=16). CBL teaching was con-ducted through the following procedures:selecting typical cases-establishing and applying typical case library-autonomous learning-holding regular seminars. Traditional teaching was conducted through the following procedures: basic theory studying-participating in clinical practice-participating in case discus-sion. Evaluation was conducted based on test socre (written test and clinical operational skill test)and res-idents' feedback of teaching effect. Data were statistically described and independent sample t test was performed. Results Theoretical exam score and clinical skill test score were high in CBL group than in traditional group ((thoretical score:(85.53 ±1.75) vs. (79.94 ±2.29);clinical skill test score:(85.10±1.64)vs.(80.31±1.82)). CBL teaching group had advantages in improving learning efficiency, cultivat-ing clinical thinking,promoting mastery and application of knowledge,broadening knowledge, promoting communication and expression ability and improving study enthusiasm ,et al . Conclusion CBL teaching can effectively improve the teaching quality and obtain higher evaluation. Typical case li-brary should be constantly improved and education of vascular surgical basic theory should be strength-ened to promote CBL.