PURPOSE: Allergic rhinitis (AR) has become a global issue for a large part of the general population. Sublingual immunotherapy (SLIT) has been used extensively to treat persistent allergic rhinitis (PAR). Although systematic reviews have confirmed the effectiveness of SLIT for the treatment of AR, a considerable number of studies using extracts of house dust mites (HDMs) for immunotherapy found no consensus on basic treatment parameters and questioned the efficacy of SLIT. METHODS: In this study, we evaluated SLIT for PAR by a meta-analysis of randomized controlled trials (RCTs). Medline, Embase, and Cochrane Library database searches were performed for RCTs on the treatment of PAR by SLIT that assessed clinical outcomes related to efficacy through May 2016. Descriptive and quantitative information was abstracted. An analysis was performed with standardized mean differences (SMDs) under a fixed or random effects model. Subgroup analyses were performed. Heterogeneity was assessed using the I2 metric. RESULTS: In total, 25 studies were eligible for inclusion in the meta-analysis for symptom scores and 15 studies for medication scores. SLIT was significantly different from the controls for symptom scores (SMD=1.23; 95% confidence interval [CI]=1.74 to 0.73; P<0.001). For medication scores, significant differences for SLIT were also observed versus the controls (SMD=-1.39; 95% CI=-1.90 to -0.88; P<0.001). CONCLUSIONS: Our meta-analysis indicates that SLIT provided significant symptom relief and reduced the need for medications in PAR. In this study, significant evidence was obtained despite heterogeneity with regard to the use of mite extract. Specifically, the mite extract used was provided by the patients with PAR. Furthermore, to confirm both the objective outcomes and the effective doses of HDM allergen extracts, experimental data should be obtained from large high-quality population-based studies.
Consensus ; Dust* ; Humans ; Immunotherapy ; Mites ; Population Characteristics ; Pyroglyphidae ; Rhinitis, Allergic* ; Sublingual Immunotherapy*

Objective To investigate and evaluate the clinical value of full endoscopic transnasal transphenoidal approach for the surgery of pituitary adenomas.Methods Seventy-two patients,who underwent full endoscopic transnasal transphenoidal approach for the surgery of pituitary adenomas,were selected from the Medical Center of Pituitary Adenomas of our hospital from January 2009 to March 2012.To retrospectively investigate pre- and post-operation symptoms,hormone levels,images information,operation information,complications,following-up information and so on.Results Among the 72 consecutive patients,there were 22 nonfunctioning adenomas,twenty-four prolactin secreting adenomas,seven somatotropin secreting adenomas,five adrenocorticotropic hormone secreting adenomas,one thyrotropin secreting adenomas,and 13 multi-secreting adenomas.The tumor removal was total in 56(77.8％),subtotal 13(18.0％),and partial 3(4.2％).Five cases had CSF leaks,and 6 diabetes insipidus.After 3-24 months of follow-up,the levels of increasing-hormone declined to normal levels in most patients.Conclusion Full endoscopic transnasal transphenoidal approach for the surgery of pituitary adenomas is a kind of technique which is safe,minimally invasive,having less complications and fast recovery.However,it is necessary for surgeons to accept systematic and specialized training,and own advanced equipments.

OBJECTIVE To investigate the drug-resistant genes in Acinetobacter baumannii(ABA) isolated from Shaoxing and the relationship among them to supply evidences for tracing the source of epidemiology.METHODS Nineteen drug-resistant genes were detected by PCR in 39 strains of ABA.RESULTS TEM-gene was found positive in 13 strains of ABA(33.3%),OXA-23 group-gene was in 20 strains(51.3%),aac(3)-Ⅰ gene was in 23 strains(64.1%),aac(6′)-Ⅰ gene was in 25 strains(64.1%),ant(3″)-Ⅰ gene was in 29 strains(74.4%) and qacE△1-sul1 gene was in 32 strains(81.2%).The others were not found in all 39 isolates detected.Clonial transmitted phenomenon was existed.CONCLUSIONS The carrier rate of TEM,OXA-23group,aac(3)-Ⅰ,aac(6′)-Ⅰ,ant(3″)-Ⅰ and qacE△1-sul1 genes is high in ABA.ABA can induce clonial transmitted hospital infection.

OBJECTIVE To study the antibiotic resistance of Staphylococcus isolated from the burn patient wounds. METHODS The sensitivity to 14 common antimicrobial agents was deteded by K-B method. MRSA and MRCNS were detected by cefoxitin disk;the inducible resistance to clindamycin was detected by D-test. RESULTS There were 378 strains of Staphylococcus isolated from the burn patient wounds. The isolation rates of Staphylococcus epidermidis,S. aureus and S. haemolyticus were 43.1%,41.6% and 11.1%. Antibiotic resistance rate to vancomycin,teicoplanin,minocycline,rifapin and nitrofurantoin was 0.0-19.0%,the resistance rate to other antibiotics was 54.1-100.0%. The detection rate of MRSA was 81.5%,the detection rate of MRCNS among S. epidermidis and S. haemolyticus was 55.6% and 66.7%. The total positive rate of D-test was 48.2% in Staphylococcus which were sensitive to clindamycin but resistant to erythromycin. The positive rate of S. aureus,S. epidermidis and S. haemolyticus were 49.1%,44.2% and 57.1%. CONCLUSIONS Staphylococcus are ones of the important pathogens which make burn wound infection happen and the antimicrobial resistance is increasingly severe. The high positive results of MRSA and D-test make great trouble to therapy,and that should have taken more attention of clinic.

OBJECTIVE To investigate the drug-resistance and aminoglycoside modifying enzymes (AME) in Acinetobacter baumannii (ABA) isolated from ICU. METHODS K-B method was conducted to detect the sensitivity to 14 common antibiotics of 291 strains of ABA isolated from 2005 to 2007;PCR was used to detect AME genes of partial bacteria isolated in 2005. RESULTS The drug-resistance rates of 13 kinds of antibiotics were 33.0-91.8%,but cefoperazone/sulbactam was low (12.7%). The rate of amikacin,gentamicin and tobramycin was 41.2%,61.2% and 61.5%. Twenty-three ABA strains were AME gene positive from total 27 ABA strains and the total positive rate was 74.4%.We found 21 strains with aac(3)-Ⅰ (77.8%),23 strains with aac(6′)-Ⅰ (85.2%) and 23 strains with ant(3″)-Ⅰ (85.2%). Two strains were found to have 2 kinds of AME genes,21 strains had 3 kinds of AME genes. The rest of ABA strains had not AME genes. CONCLUSIONS ABA isolated from ICU has strong drug-resistance rate and a high carrier rate,it is a critical area of preventing and controlling hospital infection.

OBJECTIVE To analyze the distribution and drug-resistance of Klebsiella pneumoniae isolated from clinic in the past two years to help doctors to use antibiotic reasonably.METHODS To detect the drug-resistance of 470 strains of K.pneumoniae to 15 kinds of antimicrobial agents were detected by K-B method,and the AmpC ?-lactamase and ESBLs were detected through the way of 3-D test.RESULTS ICU and burn department were found where had the highest isolation rate,and sputum and wound that had the highest detection rate.Sensitivity test results showed that the resistance rate of K.pneumoniae to penicillins,first and second-generation cepholosporins,fluoroquinolones and sulfamethoxazole compound was high(51.1-88.3%),and resistance rate to the third and fourth-generation cephalosporins was high,too(32.6-40.4%).All strains were sensitive to imipenem,but two of them were resistant to meropenem.ESBLs were found in 152 strains,the detection rate was 32.3%,AmpC was found in 29 strains,the detection rate was 6.2%.Both of them were found out in 21 strains.CONCLUSIONS The lower respiratory tract infection is the most common one.The ICU and wound ward are the high-risk places ward of infection.Detection rate and drug resistance are increasingly severe,clinic and laboratory should make concerted efforts to reduce nosocomial infection and strengthen information feedback.

OBJECTIVE To analyze the drug-resistance of Enterobacter cloacae isolated from clinic in the past two years.METHODS The drug-resistance by K-B method,and to perform 3-D test to detect AmpC ?-lactamase and ESBLs were detected.RESULTS One hundred and six strains of E.cloacae was detected.Burn department were the wards which had the highest detection rate.Sputum,wound,bile and drainage fluid had the highest positive rate.Sensitivity test results showed that the resistance rate to penicilins,Ⅰ,Ⅱ-generation cephalosporins and cefoxitin of E.cloacae was the highest,and the resistance rate to the third,and fourth-generation cephalosporins was 24.5-50.9%.The detection rate of ESBLs and AmpC was 27.4% and 40.6%,respectively.Twenty three strains produced both of them.CONCLUSIONS The detection rate and drug resistance of E.cloacae are increasing severely.Laboratory should pay more attention to their detections and surveillance so as to control hospital infection of E.cloacae.

Objective To investigate the genotyping of aminoglycoside modifying enzymes on Pan-drug resistant A..baumannii(PDRA)isolated.Methods The antibiotic susceptibility of 16 different antibiotics of A.baumannii were tested by K-B method,aminoglycoside modifying enzymes coding genes of A.baumannii were detected by PCR.Results The detection rates of OXA-23group were 41.8%and aminoglycoside modifying enzymes coding genes of aac(3)-Ⅰ,aac(6')-Ⅰand ant(3″)-Ⅰ were 64.1%,64.1% and 74.4%.Conclusions The study showed that it is more serious for PDRA carrying aminoglycoside modifying enzymes coding genes.

Objective By analyzing the dgug-resistance of Acinetobacter baumannii got from clinic in recent 3 years to study the therapy method of pan resistant bacteria.Method Bacteria was got from sputum or trachea pipe of patients normally,identified with ATB and test 14 common antibiotic drugs by K-B method.Result All the drug-sensitive test results of 248 bacteria in 3 years show that drug-resistance rate is high(40.3%~89.5%)except for IPM,IMI and sulbactam(11.7%~15.3%),and pan resistant bacteria(resist 4 or more kinds of antibiotic drugs)is 37.1%.Conclusion Acinetobacter baumannii is the main pathogen of lower respiratory tract infection.The high picks out rate and high drug resistance get great trouble to therapy.We need to make a strict standards of asepsis operation,strengthen monitoring the drug resistance and advocate to use antibiotic drugs reasonably,so that we can prevent and control the prevalence of Acinetobacter baumannii.

OBJECTIVE To study the antimicrobial agents resistance of Staphylococcus aureus isolated from clinic.METHODS To test the sensitivity of 20 common antimicrobial agents by K-B.MRSA was detected by cefoxitin disk;and the inducible resistance of clindamycin was detected by D-test.RESULTS The drug resistance rate of this term of S.aureus was high.Except vancomycin,minocycline,teicoplanin,nitrofurantoin and rifampin,the drug resistance rate was higher than 42.6%.From 312 strains of S.aureus 209 strains of MRSA were detected,the rate was 67.0%.The structural antimicrobial resistance rate of clindamycin was 29.5%,the detection rate of inducible resistance was 51.4%.CONCLUSIONS The antimicrobial resistance of S.aureus is increasingly severe.The high positive results of MRSA and D-test make great trouble to therapy,and should have taken more attention of clinic.