Objective To investigate the prevalence of specific IgE antibodies against Alternaria alternata and Aspergillus fumigatus in serum samples from clinical allergy patients across selected provinces in China.Methods Data on specific IgE antibodies for Alternaria A.and Aspergillus F.were collected from 20 hospital laboratories in 17 cities spanning 11 provinces.The study analyzed the levels of specific IgE and their variations across different provinces and seasons.Results A total of 27 471 cases of Alternaria A.and 32 843 cases of Aspergillus F.specific IgE data were included.The national average positive rate of Alternaria A.IgE was 10.40%,with the highest rate of 22.68%in Jiangsu and the lowest rate of 2.06%in Guangxi.For Aspergillus F.specific IgE,the average positive rate was 4.24%,with Hubei province having the highest rate(7.25%)and Hunan province the lowest(1.23%).The difference in IgE levels for both Alternaria A.and Aspergillus F.among provinces were statistically significant(H=9 955,16 993,all P<0.0001).Among patients,5.85%had Alternaria A.specific IgE levels at grade 3 or above,while only 0.57%had Aspergillus F.specific IgE levels at this level.When examining seasonal variations using data from Liaoning,Hunan and Anhui provinces,significant seasonal changes were observed for both Alternaria A.and Aspergillus F.IgE antibodies(HAlternaria A=347.6,338.0,401.3,HAspergillus F=196.6,133.7,231.7,all P<0.0001).Conclusion The sensitization to Alternaria A.and Aspergillus F.exhibits distinct geographical characteristics and vary significantly with seasons.Given the relatively high IgE levels associated with Alternaria A.,it should be given adequate clinical attention.

OBJECTIVE: This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study. METHODS: A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants. RESULTS: Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m ²) presented an increase in all-cause mortality (adjusted hazards ratio [ aHR] = 2.00, 95% confidence interval [ CI]: 1.66-2.41), while overweight (≥ 24.0 to < 28.0 kg/m ²) and obesity (≥ 28.0 kg/m ²) presented a decrease with an aHR of 0.61 (95% CI: 0.52-0.73) and 0.51 (95% CI: 0.37-0.70), respectively. Overweight ( aHR = 0.76, 95% CI: 0.67-0.86) and mild obesity ( aHR = 0.72, 95% CI: 0.59-0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m ² ( aHR = 0.95, 95% CI: 0.92-0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses. CONCLUSION This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.
Humans ; Body Mass Index ; China/epidemiology* ; Male ; Female ; Middle Aged ; Prospective Studies ; Rural Population/statistics & numerical data* ; Aged ; Follow-Up Studies ; Adult ; Mortality ; Cause of Death ; Obesity/mortality* ; Overweight/mortality*

OBJECTIVES: To evaluate the effectiveness of single-balloon and double-balloon enteroscopy in diagnosing pediatric small bowel diseases and assess the diagnostic efficacy of computed tomography enterography (CTE) for small bowel diseases using enteroscopy as the reference standard. METHODS: Clinical data from 576 children who underwent enteroscopy at Hunan Children's Hospital between January 2017 and December 2023 were retrospectively collected. The children were categorized based on enteroscopy type into the single-balloon enteroscopy (SBE) group (n=457) and double-balloon enteroscopy (DBE) group (n=119), and the clinical data were compared between the two groups. The sensitivity and specificity of CTE for diagnosing small bowel diseases were evaluated using enteroscopy results as the standard. RESULTS: Among the 576 children, small bowel lesions were detected by enteroscopy in 274 children (47.6%).There was no significant difference in lesion detection rates or complication rates between the SBE and DBE groups (P>0.05), but the DBE group had deeper insertion, longer procedure time, and higher complete small bowel examination rate (P<0.05). The complication rate during enteroscopy was 4.3% (25/576), with 18 cases (3.1%) of mild complications and 7 cases (1.2%) of severe complications, which improved with symptomatic treatment, surgical, or endoscopic intervention. Among the 412 children who underwent CTE, the sensitivity and specificity for diagnosing small bowel diseases were 44.4% and 71.3%, respectively. CONCLUSIONS SBE and DBE have similar diagnostic efficacy for pediatric small bowel diseases, but DBE is preferred for suspected deep small bowel lesions and comprehensive small bowel examination. Enteroscopy in children demonstrates relatively good overall safety. CTE demonstrates relatively low sensitivity but comparatively high specificity for diagnosing small bowel diseases.
Retrospective Studies ; Treatment Outcome ; Double-Balloon Enteroscopy/statistics & numerical data* ; Single-Balloon Enteroscopy/statistics & numerical data* ; Humans ; Male ; Female ; Child ; Operative Time ; Tomography, X-Ray Computed/statistics & numerical data* ; Sensitivity and Specificity ; Intestine, Small/surgery* ; Intestinal Diseases/surgery*

Objective To investigate the prevalence of specific IgE antibodies against Alternaria alternata and Aspergillus fumigatus in serum samples from clinical allergy patients across selected provinces in China.Methods Data on specific IgE antibodies for Alternaria A.and Aspergillus F.were collected from 20 hospital laboratories in 17 cities spanning 11 provinces.The study analyzed the levels of specific IgE and their variations across different provinces and seasons.Results A total of 27 471 cases of Alternaria A.and 32 843 cases of Aspergillus F.specific IgE data were included.The national average positive rate of Alternaria A.IgE was 10.40%,with the highest rate of 22.68%in Jiangsu and the lowest rate of 2.06%in Guangxi.For Aspergillus F.specific IgE,the average positive rate was 4.24%,with Hubei province having the highest rate(7.25%)and Hunan province the lowest(1.23%).The difference in IgE levels for both Alternaria A.and Aspergillus F.among provinces were statistically significant(H=9 955,16 993,all P<0.0001).Among patients,5.85%had Alternaria A.specific IgE levels at grade 3 or above,while only 0.57%had Aspergillus F.specific IgE levels at this level.When examining seasonal variations using data from Liaoning,Hunan and Anhui provinces,significant seasonal changes were observed for both Alternaria A.and Aspergillus F.IgE antibodies(HAlternaria A=347.6,338.0,401.3,HAspergillus F=196.6,133.7,231.7,all P<0.0001).Conclusion The sensitization to Alternaria A.and Aspergillus F.exhibits distinct geographical characteristics and vary significantly with seasons.Given the relatively high IgE levels associated with Alternaria A.,it should be given adequate clinical attention.

Objective To explore the efficacy and safety of recombinant human anti-severe acute respiratory syn-drome coronavirus 2(anti-SARS-CoV-2)monoclonal antibody injection(F61 injection)in the treatment of patients with coronavirus disease 2019(COVID-19)combined with renal damage.Methods Patients with COVID-19 and renal damage who visited the PLA General Hospital from January to February 2023 were selected.Subjects were randomly divided into two groups.Control group was treated with conventional anti-COVID-19 therapy,while trial group was treated with conventional anti-COVID-19 therapy combined with F61 injection.A 15-day follow-up was conducted after drug administration.Clinical symptoms,laboratory tests,electrocardiogram,and chest CT of pa-tients were performed to analyze the efficacy and safety of F61 injection.Results Twelve subjects(7 in trial group and 5 in control group)were included in study.Neither group had any clinical progression or death cases.The ave-rage time for negative conversion of nucleic acid of SARS-CoV-2 in control group and trial group were 3.2 days and 1.57 days(P=0.046),respectively.The scores of COVID-19 related target symptom in the trial group on the 3rd and 5th day after medication were both lower than those of the control group(both P＜0.05).According to the clinical staging and World Health Organization 10-point graded disease progression scale,both groups of subjects improved but didn't show statistical differences(P＞0.05).For safety,trial group didn't present any infusion-re-lated adverse event.Subjects in both groups demonstrated varying degrees of elevated blood glucose,elevated urine glucose,elevated urobilinogen,positive urine casts,and cardiac arrhythmia,but the differences were not statistica-lly significant(all P＞0.05).Conclusion F61 injection has initially demonstrated safety and clinical benefit in trea-ting patients with COVID-19 combined with renal damage.As the domestically produced drug,it has good clinical accessibility and may provide more options for clinical practice.

Objective:To construct a scientific performance evaluation index system for online contracted nurses and provide evaluation tools for managers to evaluate their performance.Methods:Based on the KRIF theory, literature search, qualitative interview results initially constructed performance evaluation indexes of online contracted nurses, used Delphi method to carry out two rounds of expert correspondence from April to July, 2023, and used hierarchical analysis to determine the performance evaluation index system of online contracted nurses and the weights of the indexes at all levels.Results:The questionnaire recovery rate of the two rounds of expert correspondence was 18/18, the coefficient of basis of judgment was 0.91, the coefficient of familiarity was 0.89 and 0.86, the coefficient of authority was 0.90 and 0.89, and the coefficient of coordination of experts was 0.222 and 0.190, respectively (all P<0.001), and finally formed the performance evaluation index system of online contracted nurses including 4 first-level indexes, 9 second-level indexes, and 32 tertiary indicators. Conclusions:The performance evaluation index system of online contracted nurses based on the KRIF model covers various aspects, is scientific, reliable and comprehensive, and can provide a reference basis for the performance evaluation management of online nurses.

Malocclusion,identified by the World Health Organization(WHO)as one of three major oral diseases,profoundly impacts the dental-maxillofacial functions,facial esthetics,and long-term development of～260 million children in China.Beyond its physical manifestations,malocclusion also significantly influences the psycho-social well-being of these children.Timely intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition,by mitigating the negative impact of abnormal environmental influences on the growth.Early orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development,ranging from fetal stages to the early permanent dentition phase.From an economic and societal standpoint,the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated,underlining its profound practical and social importance.This consensus paper discusses the characteristics and the detrimental effects of malocclusion in children,emphasizing critical need for early treatment.It elaborates on corresponding core principles and fundamental approaches in early orthodontics,proposing comprehensive guidance for preventive and interceptive orthodontic treatment,serving as a reference for clinicians engaged in early orthodontic treatment.

Objective To explore the clinical efficacy of double beam double tunnel enhanced reconstruction technique in the treatment of knee anterior cruciate ligament(ACL)training injuries.Methods Twenty-nine cases of ACL injury of knee joint from January 2021 to December 2021 were retrospectively analyzed.All the cases were underwent ligament reconstruc-tion surgery.Cases were grouped by surgical technique:there were 14 patients in conventional reconstruction group,including 13 males and 1 female,aged from 22 to 31 years old with an average of(27.07±7.28)years old,autogenous hamstring tendon was used for ligament reconstruction.There were 15 patients in the enhanced reconstruction group,including 13 males and 2 females,aged from 25 to 34 years old with an average of(29.06±4.23)years old,double tunnel ligament reconstruction,the autogenous hamstring muscle was used as the anteromedial bundle,and the posterolateral bundle was replaced by a high-strength line.The difference between knee tibial anterior distance,Lysholm score,International Knee Literature Committee(IKDC)subjective score,Tegner motor level score and visual analog scale(VAS)at 6th and 12th months after the surgery,limb symmetry index(LSI)were recorded at the last follow-up and surgery-related adverse effects during follow-up.Results All patients were followed up,ranged from 13 to 15 months with an average of(13.7±0.8)months.There were no serious adverse reactions related to surgery during the period.There was no statistical difference between the preoperative general data and the observation index of the two groups(P＞0.05).The difference in tibial anterior distance at 6 and 12 months in the enhanced re-construction group(1.45±0.62)mm and(1.74±0.78)mm which were lower those that in the conventional reconstruction group(2.42±0.60)mm and(2.51±0.63)mm(P＜0.05).There was no significant difference in postoperative Lysholm score,Tegner motor level score,IKDC score,VAS,and limb symmetry index at the last follow-up(P＞0.05).Conclusion The enhanced recon-struction technique can more effectively maintain the stability of the knee joint and has no significant effect on the postoperative knee joint function compared with the traditional ligament reconstruction technique.The short-term curative effect is satisfac-tory,and it is suitable for the group with high sports demand.

Objective To study the effects of Jinshui Liujun decoction(JLD)on airway inflammation and interferon-γ(IFN-γ)/interleukin-4(IL-4)imbalance in asthma.Methods The ovalbumin(OVA)was used to replicate the asthmatic mouse by injection and nebulization inhalation.Asthmatic mice were randomly divided into model group,positive control group(1.0 mg·kg-1 dexamethasone)and experimental-L,-M,-H groups(4.1,8.2 and 16.4 g·kg-1 JLD).The blank group and the model group were given purified water by gavage for 2 consecutive weeks.The lung function[tidal volume(TV)and respiratory rate(RR)]of mice was measured by lung function test system after administering JLD by gavage.IFN-γ,IL-4 in bronchoalveolar lavage fluid(BALF)and their genes in lung tissue were determined through enzyme-linked immunosorbent assay and quantitative real-time polymerase chain reaction respectively.Results The TV levels in blank group,model group,positive control group and experimental-L,-M,-H groups were(118.90±24.20),(87.10±13.36),(112.70±18.92),(105.20±15.24),(107.60±16.47)and(110.10±17.41)μL;RR levels were(126.60±17.57),(178.80±31.06),(133.00±19.45),(146.00±25.82),(141.30±24.78)and(137.00±22.81)bpm;IFN-γ levels were(110.95±9.26),(60.16±2.75),(98.09±8.21)、(79.58±6.49)、(88.16±7.58)and(97.26±7.23)pg·mL-1;IL-4 levels were(118.06±8.47)、(416.08±22.21)、(272.17±13.14)、(319.34±15.27)、(298.77±14.83)and(278.71±14.24)pg·mL-1;the IFN-γ mRNA levels were 2.70±0.08,1.00±0.00,2.65±0.06,1.89±0.04,2.24±0.05 and 2.58±0.06;IL-4 mRNA levels were 0.25±0.02,1.00±0.00,0.26±0.02,0.61±0.05,0.50±0.03 and 0.33±0.03,respectively.There were statistically significant differences between the above indicators of model group and blank group,and experimental-L,-M,-H groups and model group(P＜0.05,P＜0.01).Conclusion JLD has a certain antiasthmatic effect and one of mechanisms is to alleviate the IFN-γ/IL-4 immune imbalance and inhibit airway inflammation.

Objective To study the effects of Jinshui Liujun decoction(JLD)on airway inflammation and interferon-γ(IFN-γ)/interleukin-4(IL-4)imbalance in asthma.Methods The ovalbumin(OVA)was used to replicate the asthmatic mouse by injection and nebulization inhalation.Asthmatic mice were randomly divided into model group,positive control group(1.0 mg·kg-1 dexamethasone)and experimental-L,-M,-H groups(4.1,8.2 and 16.4 g·kg-1 JLD).The blank group and the model group were given purified water by gavage for 2 consecutive weeks.The lung function[tidal volume(TV)and respiratory rate(RR)]of mice was measured by lung function test system after administering JLD by gavage.IFN-γ,IL-4 in bronchoalveolar lavage fluid(BALF)and their genes in lung tissue were determined through enzyme-linked immunosorbent assay and quantitative real-time polymerase chain reaction respectively.Results The TV levels in blank group,model group,positive control group and experimental-L,-M,-H groups were(118.90±24.20),(87.10±13.36),(112.70±18.92),(105.20±15.24),(107.60±16.47)and(110.10±17.41)μL;RR levels were(126.60±17.57),(178.80±31.06),(133.00±19.45),(146.00±25.82),(141.30±24.78)and(137.00±22.81)bpm;IFN-γ levels were(110.95±9.26),(60.16±2.75),(98.09±8.21)、(79.58±6.49)、(88.16±7.58)and(97.26±7.23)pg·mL-1;IL-4 levels were(118.06±8.47)、(416.08±22.21)、(272.17±13.14)、(319.34±15.27)、(298.77±14.83)and(278.71±14.24)pg·mL-1;the IFN-γ mRNA levels were 2.70±0.08,1.00±0.00,2.65±0.06,1.89±0.04,2.24±0.05 and 2.58±0.06;IL-4 mRNA levels were 0.25±0.02,1.00±0.00,0.26±0.02,0.61±0.05,0.50±0.03 and 0.33±0.03,respectively.There were statistically significant differences between the above indicators of model group and blank group,and experimental-L,-M,-H groups and model group(P＜0.05,P＜0.01).Conclusion JLD has a certain antiasthmatic effect and one of mechanisms is to alleviate the IFN-γ/IL-4 immune imbalance and inhibit airway inflammation.