Objective:The prevalence of seasonal allergic rhinitis （AR） and its combined diseases have been increasing recently. The purpose was to investigate the clinical characteristics and treatment of seasonal AR in northern China. Methods:A cross-sectional study was conducted in AR patients. The Visual analogue scale （VAS）, combined diseases, clinical features, allergic pollen and treatments were analyzed. Results:Of the 789 AR subjects included, 54.1% had a family history of atopic disease. The mian course wa s（7.4±5.9） years. 95.4% of the subjects had moderate to severe AR. The prevalence rates of allergic conjunctivitis （AC）, allergic asthma （AA）, and pollen food allergy syndrome （PFAS） were 71.1%, 19.0%, and 39.5% respectively. Among the patients, 13.8% presented with only AR, while 39.3% had an AR combined with other disease, and 1.9% exhibited comorbidity involving five different diseases. VAS was positively correlated with the number of comorbidities（r=0.186, P<0.001）. The mugwort exhibited the highest rate of pollen sensitization （48.9%）, closely followed by cypress （48.3%）. The prevalence of mono-sensitization to pollen was 20.2%, while the positive rates for double-sensitized pollens and more than three sensitized pollens were 17.4% and 62.4%, respectively. Among the study participants, 19.9% did not receive any form of treatment, while 66.2% were administered oral medication and 27.5% underwent nasal steroid spray therapy. The proportion of individuals receiving anti-IgE monoclonal antibodies was 4.3%, and allergen immunotherapy （AIT） treatment was undergone by 11.8%. Meanwhile, 41.2% of patients undergoing anti-IgE monoclonal antibody treatment also received AIT. The distribution of therapy types among patients was as follows: 44.7% received a single type, 22.2% received two types, and 9.8% received three types of therapy. Additionally, there was a subset of patients（1%） who were undergoing five distinct forms of treatment. The VAS score exhibited a significant negative correlation with no treatment（r=-0.199, P<0.001）, while it showed a positive association with the number of treatment modalities（r=0.245, P<0.001）. Conclusion:Mugwort and cypress are the predominant allergenic pollens responsible for seasonal AR in northern China. The majority of cases present with moderate to severe AR, often accompanied by various comorbidities, necessitating consideration of diverse treatment modalities. However, the current rate of adoption for AIT remains relatively insufficient.
Humans ; China/epidemiology* ; Cross-Sectional Studies ; Rhinitis, Allergic, Seasonal/therapy* ; Pollen/immunology* ; Adult ; Male ; Female ; Young Adult ; Adolescent ; Middle Aged ; Child ; Prevalence ; Allergens/immunology* ; Asthma/epidemiology* ; Conjunctivitis, Allergic

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 evaluate the accuracy and safety profile of a novel cuboid orientation-guided frontal horn ventriculostomy technique in patients with large hemispheric infarction (LHI).Methods:It was conducted a retrospective cohort study of 48 consecutive LHI patients who underwent the innovative ventriculostomy procedure between time period. Primary outcomes included procedural accuracy (success rates, catheter positioning) and safety indicators (complication rates).Results:All the punctured ventricles were small or of normal size. The success rate of puncture was 100%, the success rate of one-time puncture was 87% (42/48), and the average number of puncture was 1.13 times per case. The ratio of well-positioned tube heads was 87.5% (42/48). The actual angle of the inward deviation of the puncture ranged from -2o to 5o, with an average of 0o±0.3o. The depth of puncture was 7.0-8.0 cm ( 7.3±0.3) cm. The incidence of bleeding around the puncture path was 1.3% (2/48 ) and no massive bleeding occurred. At the 6-month follow-up, one case (2.94%) among the 34 survivors had epilepsy.Conclusions:The cuboid orientation-guided frontal horn ventriculostomy technique demonstrates exceptional procedural accuracy and an excellent safety profile in LHI patients, with high first-pass success rates (87.5%) and minimal complications (4.2% minor hemorrhage). These findings support its clinical adoption for this patient population.

Food allergy is a common allergic disease threatening the growth and development of infants and children.n-3 polyunsaturated fatty acids (PUFAs) are common nutrients in the diet, which have important structural functions and immunomodulatory effects.Their protective effect in food allergy has gradually become a potential research hotspot.This review highlights the function and immune regulation of PUFAs, the regulation of n-3 PUFAs on immunological indexes, the mechanism of food allergy, and the relationship between food allergy, and the impact of n-3 PUFAs on other allergic diseases.

Objective::To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta (PA).Methods::This case-control study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in seven provinces of China between January 2017 and December 2017. According to the intraoperative findings after delivery, the study population was divided into PA and non-PA groups. We compared the pregnancy outcomes between the two groups, used multivariate logistic regression to analyze the risk factors for placental accreta.Results::For this study we included 11,074 pregnant women with a history of cesarean section; and of these, 869 cases were in the PA group and 10,205 cases were in the non-PA group. Compared with the non-PA group, the probability of postpartum hemorrhage (236/10,205, 2.31% vs. 283/869, 32.57%), severe postpartum hemorrhage (89/10,205, 0.87% vs. 186/869, 21.75%), diffuse intravascular coagulation (3/10,205, 0.03% vs. 4/869, 0.46%), puerperal infection (33/10,205, 0.32% vs. 12/869, 1.38%), intraoperative bladder injury (1/10,205, 0.01% vs. 16/869, 1.84%), hysterectomy (130/10,205, 1.27% vs. 59/869, 6.79%), and blood transfusion (328/10,205,3.21 % vs. 231/869,26.58%) was significantly increased in the PA group ( P < 0.05). At the same time, the neonatal birth weight (3250.00 (2950.00-3520.00) g vs. 2920.00 (2530.00-3250.00) g), the probability of neonatal comorbidities (245/10,205, 2.40% vs. 61/869, 7.02%), and the rate of neonatal intensive care unit admission (817/10,205, 8.01% vs. 210/869, 24.17%) also increased significantly ( P < 0.05). Weight (odds ratio ( OR)= 1.03, 95% confidence interval ( CI): 1.01-1.05)), parity ( OR= 1.18, 95% CI: 1.03-1.34), number of miscarriages ( OR= 1.31, 95% CI: 1.17-1.47), number of previous cesarean sections ( OR= 2.57, 95% CI: 2.02-3.26), history of premature rupture of membrane ( OR= 1.61, 95% CI: 1.32-1.96), previous cesarean-section transverse incisions ( OR= 1.38, 95% CI: 1.12-1.69), history of placenta previa ( OR= 2.44,95% CI: 1.50-3.96), and the combination of prenatal hemorrhage ( OR= 9.95,95% CI: 8.42-11.75) and placenta previa ( OR= 91.74, 95% CI: 74.11-113.56) were all independent risk factors for PA. Conclusion::There was an increased risk of adverse outcomes in pregnancies complicated by PA in women with a history of cesarean section, and this required close clinical attention. Weight before pregnancy, parity, number of miscarriages, number of previous cesarean sections, history of premature rupture of membranes, past transverse incisions in cesarean sections, a history of placenta previa, prenatal hemorrhage, and placenta previa were independent risk factors for pregnancies complicated with PA in women with a history of cesarean section. These independent risk factors showed a high value in predicting the risk for placentab accreta in pregnancies of women with a history of cesarean section.

Objective::To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta (PA).Methods::This case-control study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in seven provinces of China between January 2017 and December 2017. According to the intraoperative findings after delivery, the study population was divided into PA and non-PA groups. We compared the pregnancy outcomes between the two groups, used multivariate logistic regression to analyze the risk factors for placental accreta.Results::For this study we included 11,074 pregnant women with a history of cesarean section; and of these, 869 cases were in the PA group and 10,205 cases were in the non-PA group. Compared with the non-PA group, the probability of postpartum hemorrhage (236/10,205, 2.31% vs. 283/869, 32.57%), severe postpartum hemorrhage (89/10,205, 0.87% vs. 186/869, 21.75%), diffuse intravascular coagulation (3/10,205, 0.03% vs. 4/869, 0.46%), puerperal infection (33/10,205, 0.32% vs. 12/869, 1.38%), intraoperative bladder injury (1/10,205, 0.01% vs. 16/869, 1.84%), hysterectomy (130/10,205, 1.27% vs. 59/869, 6.79%), and blood transfusion (328/10,205,3.21 % vs. 231/869,26.58%) was significantly increased in the PA group ( P < 0.05). At the same time, the neonatal birth weight (3250.00 (2950.00-3520.00) g vs. 2920.00 (2530.00-3250.00) g), the probability of neonatal comorbidities (245/10,205, 2.40% vs. 61/869, 7.02%), and the rate of neonatal intensive care unit admission (817/10,205, 8.01% vs. 210/869, 24.17%) also increased significantly ( P < 0.05). Weight (odds ratio ( OR)= 1.03, 95% confidence interval ( CI): 1.01-1.05)), parity ( OR= 1.18, 95% CI: 1.03-1.34), number of miscarriages ( OR= 1.31, 95% CI: 1.17-1.47), number of previous cesarean sections ( OR= 2.57, 95% CI: 2.02-3.26), history of premature rupture of membrane ( OR= 1.61, 95% CI: 1.32-1.96), previous cesarean-section transverse incisions ( OR= 1.38, 95% CI: 1.12-1.69), history of placenta previa ( OR= 2.44,95% CI: 1.50-3.96), and the combination of prenatal hemorrhage ( OR= 9.95,95% CI: 8.42-11.75) and placenta previa ( OR= 91.74, 95% CI: 74.11-113.56) were all independent risk factors for PA. Conclusion::There was an increased risk of adverse outcomes in pregnancies complicated by PA in women with a history of cesarean section, and this required close clinical attention. Weight before pregnancy, parity, number of miscarriages, number of previous cesarean sections, history of premature rupture of membranes, past transverse incisions in cesarean sections, a history of placenta previa, prenatal hemorrhage, and placenta previa were independent risk factors for pregnancies complicated with PA in women with a history of cesarean section. These independent risk factors showed a high value in predicting the risk for placentab accreta in pregnancies of women with a history of cesarean section.

To analyze the sensitization characteristics and significance of airborne allergens in chronic urticaria (CU) with airway allergic diseases (allergic rhinitis and/or asthma). From May to August 2015, the Department of allergy, Beijing Shijitan Hospital Affiliated to Capital Medical University conducted an epidemiological survey of allergic diseases in grassland area of Inner Mongolia by multistage stratified cluster sampling. The results of skin prick test (SPT) for airborne allergens in 191 patients with CU and 1 132 patients with airway allergic diseases were analyzed. The statistical data were tested by chi-square segmentation method, and the stratified trend of rate was tested by Linear-by-Linear. Among the 191 patients with CU, 92 (48.17%) had CU without airway allergic diseases (CU alone), and 99 (51.83%) had CU with airway allergic diseases. The top three air allergens were house dust mite, chenopodium pollen and salix pollen in CU alone (only one is the major local allergen), and artemisia, humulus scandens and chenopodium pollen in CU with airway allergic diseases (All are the main local allergens) and airway allergic diseases. Compared between CU alone and CU with airway allergic disease, the positive rate of allergen SPT and multiple strong positive rate were statistically significant (59.60% vs 38.04%, χ2=13.336;27.12% vs 2.86%, χ2=8.729; P<0.016 7).There was no significant difference in positive rate of skin prick, multiple positive rate, strong positive rate and multiple strong positive rate between CU with airway allergic disease and airway allergic diseases (59.60% vs 57.69%, χ2=0.136, P>0.016 7; 71.19% vs 75.20%, χ2=0.461, P>0.016 7; 54.24% vs 69.68%, χ2=5.969, P>0.016 7; 27.12% vs 37.83%, χ2=2.663, P>0.016 7), but there was significant difference in these between CU without airway allergic disease and airway allergic diseases (38.04% vs 57.69%, χ2=13.336, P<0.01; 51.43% vs 75.20%, χ2=9.745, P<0.01; 28.57% vs 69.68%, χ2=25.624, P<0.01; 2.86% vs 37.83%, χ2=17.620, P<0.01).The strong positive rate and the multiple strong positive rate of allergen increased with the increase of CU with allergic diseases, and the trend difference was statistically significant (38.04%,56.98% and 76.92%, χ2 =10.601, P<0.01; 28.57%,46.94% and 90.00%, χ2=12.085, P<0.01; 2.86%,24.49% and 40.00%, χ2=10.077, P<0.01). The allergen sensitization characteristics of CU with airway allergic diseases are similar to airway allergic diseases,and the detection of airborne allergens may have certain clinical value in the screening of risk factors for patients with CU associated with airway allergic diseases.

Objective:To investigate sensitization rate of cow′s milk in children, and explore its clinical features.Methods:This study enrolled a total of 818 patients under 18 years old with suspected food allergy who were admitted to the Allergy department in Beijing Shijitan Hospital during June 2018 to November 2020. The ImmunoCAP fluorescent enzyme-linked immunoassay system was used to quantify cow milk-specific immunoglobulin E (sIgE). Mild sensitization to cow′s milk was defined as Radio-Allergo-Sorbent-Test (RAST) class 1, moderate sensitization was defined as class 2-3 and severe sensitization was class 4-6. Statistical methods such as χ 2 test, independent sample t-test, one-way analysis of variance, and Spearman correlation analysis were used to retrospectively clarify differences of cow′s milk sensitization rate between ages of children and elaborate its clinical features. Results:Overall sensitization rate of cow′s milk reached 25.7% (210/818). Positive rate of cow milk sensitization (39.2%), cow milk sIgE levels [0.93 (0.52, 2.62)] kU/L, and moderate to severe sensitization rate (23.5%) were highest in infants aged between 0-3 years old. The sensitization rate and severity of sensitization declined with age. Most common clinical manifestation of cow milk sensitization was skin symptoms (50.0%), followed by respiratory symptoms (38.9%) and gastrointestinal symptoms (36.1%). Skin symptoms were the most common manifestation in 0-3 year-old group (47.3%), and respiratory symptoms were more common in 4-6 and 7-18 year-old groups (58.7%, 56.0%). Multiple-sensitization rate of patients with moderate to severe cow milk sensitization was 74.1%, most of which (70.4%) were co-sensitized by other food allergens, and 31.5% were co-sensitized by inhaled allergens.Conclusions:In population with age under 18 years old, infants aged between 0-3 years old suffered highest cow milk sensitization rate and increased sensitization severity. Then the severity decreased with age increasing. Patients with cow milk sensitization manifested skin symptoms most.

To analyze the sensitization characteristics and significance of airborne allergens in chronic urticaria (CU) with airway allergic diseases (allergic rhinitis and/or asthma). From May to August 2015, the Department of allergy, Beijing Shijitan Hospital Affiliated to Capital Medical University conducted an epidemiological survey of allergic diseases in grassland area of Inner Mongolia by multistage stratified cluster sampling. The results of skin prick test (SPT) for airborne allergens in 191 patients with CU and 1 132 patients with airway allergic diseases were analyzed. The statistical data were tested by chi-square segmentation method, and the stratified trend of rate was tested by Linear-by-Linear. Among the 191 patients with CU, 92 (48.17%) had CU without airway allergic diseases (CU alone), and 99 (51.83%) had CU with airway allergic diseases. The top three air allergens were house dust mite, chenopodium pollen and salix pollen in CU alone (only one is the major local allergen), and artemisia, humulus scandens and chenopodium pollen in CU with airway allergic diseases (All are the main local allergens) and airway allergic diseases. Compared between CU alone and CU with airway allergic disease, the positive rate of allergen SPT and multiple strong positive rate were statistically significant (59.60% vs 38.04%, χ2=13.336;27.12% vs 2.86%, χ2=8.729; P<0.016 7).There was no significant difference in positive rate of skin prick, multiple positive rate, strong positive rate and multiple strong positive rate between CU with airway allergic disease and airway allergic diseases (59.60% vs 57.69%, χ2=0.136, P>0.016 7; 71.19% vs 75.20%, χ2=0.461, P>0.016 7; 54.24% vs 69.68%, χ2=5.969, P>0.016 7; 27.12% vs 37.83%, χ2=2.663, P>0.016 7), but there was significant difference in these between CU without airway allergic disease and airway allergic diseases (38.04% vs 57.69%, χ2=13.336, P<0.01; 51.43% vs 75.20%, χ2=9.745, P<0.01; 28.57% vs 69.68%, χ2=25.624, P<0.01; 2.86% vs 37.83%, χ2=17.620, P<0.01).The strong positive rate and the multiple strong positive rate of allergen increased with the increase of CU with allergic diseases, and the trend difference was statistically significant (38.04%,56.98% and 76.92%, χ2 =10.601, P<0.01; 28.57%,46.94% and 90.00%, χ2=12.085, P<0.01; 2.86%,24.49% and 40.00%, χ2=10.077, P<0.01). The allergen sensitization characteristics of CU with airway allergic diseases are similar to airway allergic diseases,and the detection of airborne allergens may have certain clinical value in the screening of risk factors for patients with CU associated with airway allergic diseases.

Objective:To investigate sensitization rate of cow′s milk in children, and explore its clinical features.Methods:This study enrolled a total of 818 patients under 18 years old with suspected food allergy who were admitted to the Allergy department in Beijing Shijitan Hospital during June 2018 to November 2020. The ImmunoCAP fluorescent enzyme-linked immunoassay system was used to quantify cow milk-specific immunoglobulin E (sIgE). Mild sensitization to cow′s milk was defined as Radio-Allergo-Sorbent-Test (RAST) class 1, moderate sensitization was defined as class 2-3 and severe sensitization was class 4-6. Statistical methods such as χ 2 test, independent sample t-test, one-way analysis of variance, and Spearman correlation analysis were used to retrospectively clarify differences of cow′s milk sensitization rate between ages of children and elaborate its clinical features. Results:Overall sensitization rate of cow′s milk reached 25.7% (210/818). Positive rate of cow milk sensitization (39.2%), cow milk sIgE levels [0.93 (0.52, 2.62)] kU/L, and moderate to severe sensitization rate (23.5%) were highest in infants aged between 0-3 years old. The sensitization rate and severity of sensitization declined with age. Most common clinical manifestation of cow milk sensitization was skin symptoms (50.0%), followed by respiratory symptoms (38.9%) and gastrointestinal symptoms (36.1%). Skin symptoms were the most common manifestation in 0-3 year-old group (47.3%), and respiratory symptoms were more common in 4-6 and 7-18 year-old groups (58.7%, 56.0%). Multiple-sensitization rate of patients with moderate to severe cow milk sensitization was 74.1%, most of which (70.4%) were co-sensitized by other food allergens, and 31.5% were co-sensitized by inhaled allergens.Conclusions:In population with age under 18 years old, infants aged between 0-3 years old suffered highest cow milk sensitization rate and increased sensitization severity. Then the severity decreased with age increasing. Patients with cow milk sensitization manifested skin symptoms most.