Objective To explore the value of intensity ratio(IR)of lesion to non-tumor liver parenchyma on contrast-enhanced ultrasound(CEUS)Kupffer phase for differentiating hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(IHC)/metastatic liver carcinoma.Methods Totally 54 patients with HCC(HCC group),30 with IHC and 51 with liver metastatic carcinoma(non-HCC group)diagnosed by pathology were retrospectively enrolled.Quantitative parameters derived from CEUS time-intensity curves,including peak intensity(PI),time to peak(TTP),wash-in area under the curve(WiAUC),wash-out area under the curve(WoAUC),wash-in and wash-out area under the curve(WiWoAUC)of lesion in vascular phase and IR of lesion to non-tumor liver parenchyma in Kupffer phase were compared between groups,and a combined diagnostic model was established based on parameters being significantly different between groups using binary logistic regression analysis.Receiver operating characteristic(ROC)curves were plotted,and the area under the curves(AUC)were calculated to evaluate the efficacy of each CEUS parameter alone and the combined model for differentiating HCC and IHC/liver metastatic carcinoma.Results In HCC group,PI,WoAUC and WiWoAUC were all higher(all P＜0.001),while IR was significantly lower than those in non-HCC group(P＜0.001).The AUC of PI,WoAUC,WiWoAUC and IR for differentiating HCC and IHC/metastatic liver carcinoma was 0.673,0.741,0.738 and 0.736,respectively,all lower than that of combined model(0.862,all P＜0.05).Conclusion IR of lesion to non-tumor liver parenchyma on CEUS Kupffer phase could be used to differentiate HCC and IHC/metastatic liver carcinoma.Combining with quantitative parameters on CEUS vascular phase could improve differentiating efficiency.

Objective To explore the value of intensity ratio(IR)of lesion to non-tumor liver parenchyma on contrast-enhanced ultrasound(CEUS)Kupffer phase for differentiating hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(IHC)/metastatic liver carcinoma.Methods Totally 54 patients with HCC(HCC group),30 with IHC and 51 with liver metastatic carcinoma(non-HCC group)diagnosed by pathology were retrospectively enrolled.Quantitative parameters derived from CEUS time-intensity curves,including peak intensity(PI),time to peak(TTP),wash-in area under the curve(WiAUC),wash-out area under the curve(WoAUC),wash-in and wash-out area under the curve(WiWoAUC)of lesion in vascular phase and IR of lesion to non-tumor liver parenchyma in Kupffer phase were compared between groups,and a combined diagnostic model was established based on parameters being significantly different between groups using binary logistic regression analysis.Receiver operating characteristic(ROC)curves were plotted,and the area under the curves(AUC)were calculated to evaluate the efficacy of each CEUS parameter alone and the combined model for differentiating HCC and IHC/liver metastatic carcinoma.Results In HCC group,PI,WoAUC and WiWoAUC were all higher(all P＜0.001),while IR was significantly lower than those in non-HCC group(P＜0.001).The AUC of PI,WoAUC,WiWoAUC and IR for differentiating HCC and IHC/metastatic liver carcinoma was 0.673,0.741,0.738 and 0.736,respectively,all lower than that of combined model(0.862,all P＜0.05).Conclusion IR of lesion to non-tumor liver parenchyma on CEUS Kupffer phase could be used to differentiate HCC and IHC/metastatic liver carcinoma.Combining with quantitative parameters on CEUS vascular phase could improve differentiating efficiency.

Objective:To investigate the correlation between serum Chemerin and nerve growth associated protein (GAP) -43 levels and hyperhomocysteinemia (HHcy) in acute ischemic stroke.Methods:The clinical data of 149 patients with acute ischemic stroke admitted to the Sun Simiao Hospital of Beijing University of Traditional Chinese Medicine from March 2021 to May 2023 were retrospectively analyzed, and the patients were divided into observation group (97 cases) and control group (52 cases) according to whether they were combined with HHcy. Observation group patients were divided into mild group ( n=29), moderate group ( n=38) and severe group ( n=30) according to the severity of the disease. The serum Chemerin and GAP-43 levels of the observation group and the control group were compared, and the serum Chemerin and GAP-43 levels of the observation group with different severity of disease were compared, and the correlation between the serum Chemerin and GAP-43 levels and the severity of acute ischemic stroke patients with HHcy was analyzed. The influencing factors of poor prognosis in patients with acute ischemic stroke complicated with HHcy were analyzed, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum Chemerin and GAP-43 for poor prognosis in patients with acute ischemic stroke complicated with HHcy. Results:The levels of Chemerin and GAP-43 in the observation group were higher than those in the control group (all P<0.05). Serum Chemerin and GAP-43 levels in the severe group were higher than those in the mild group and the moderate group (all P<0.05), and serum Chemerin and GAP-43 levels in the moderate group were higher than those in the mild group (all P<0.05). Pearson correlation analysis showed that serum Chemerin and GAP-3 levels were positively correlated with the severity of acute ischemic stroke patients with HHcy ( r=0.458, 0.497, all P<0.05). Among 97 patients with acute ischemic stroke complicated with HHcy, 19 had poor prognosis and 78 had good prognosis. In the poor prognosis group, the proportion of diabetes, the severity of the disease and the levels of blood glucose, C-reactive protein (CRP), vascular endothelial growth factor (VEGF) and malondialdehyde (MDA) were higher than those in the good prognosis group (all P<0.05), and the superoxide dismutase (SOD) was lower than those in the good prognosis group ( P<0.05). Logistic regression analysis showed that the severity of the disease, CRP, Chemerin and GAP-43 were the influential factors for the poor prognosis of acute ischemic stroke patients with HHcy (all P<0.05). ROC curve results showed that the area under the curve (AUC) of serum Chemerin and GAP-43 levels and their combination in predicting poor prognosis of acute ischemic stroke patients with HHcy were 0.799, 0.804 and 0.907, respectively, and the AUC of the combination was larger ( P<0.05). Conclusions:Serum Chemerin and GAP-43 levels are closely related to the severity and prognosis of acute ischemic stroke patients with HHcy, and their combined value is higher in predicting poor prognosis.

Objective To observe the correlations of conventional ultrasound and contrast-enhanced ultrasound(CEUS)features with expression level of Ki-67 of intrahepatic cholangiocarcinoma(ICC).Methods A total of 77 patients with pathologically confirmed ICC were retrospectively enrolled.According to the expression level of Ki-67 of target lesions,the patients were divided into high expression group(Ki-67≥20%,n=53)and low expression group(Ki-67＜20%,n=24).The features showed on conventional ultrasound and CEUS were compared between groups,and the variables being significantly different were analyzed with multivariate logistic regression to select ultrasonic features being correlated with Ki-67 expression level of ICC.Results The mean maximum diameter of ICC in high expression group was larger than that in low expression group([6.2±2.0]cm vs.[5.2±1.9]cm,P=0.041),and the percentage of ICC with maximum diameter>5 cm in high expression group was higher than that in low expression group(66.04%vs.33.33%,P=0.007).No significant difference of the lesions shape,border nor the internal echogenicity showed on conventional ultrasound was found between groups(all P＞0.05).The percentage of ICC with peripheral rim enhancement and enlargement after enhancement in high expression group were both higher than those in low expression group(both P＜0.05),but no significant difference of the enhancement pattern,the presence or absence of non-enhance area within the lesion nor the peak intensity of lesions was found between groups(all P＞0.05).The maximum diameter larger than 5 cm(OR=5.612,P=0.004)and peripheral rim enhancement(OR=3.880,P=0.025)were both independent factors for predicting high Ki-67 expression level of ICC.Conclusion ICC with the maximum diameter larger than 5 cm and peripheral rim enhancement on CEUS might indicate high expression level of Ki-67,which was helpful for clinical treatment decisions.

Objective:To investigate the correlation between serum Chemerin and nerve growth associated protein (GAP) -43 levels and hyperhomocysteinemia (HHcy) in acute ischemic stroke.Methods:The clinical data of 149 patients with acute ischemic stroke admitted to the Sun Simiao Hospital of Beijing University of Traditional Chinese Medicine from March 2021 to May 2023 were retrospectively analyzed, and the patients were divided into observation group (97 cases) and control group (52 cases) according to whether they were combined with HHcy. Observation group patients were divided into mild group ( n=29), moderate group ( n=38) and severe group ( n=30) according to the severity of the disease. The serum Chemerin and GAP-43 levels of the observation group and the control group were compared, and the serum Chemerin and GAP-43 levels of the observation group with different severity of disease were compared, and the correlation between the serum Chemerin and GAP-43 levels and the severity of acute ischemic stroke patients with HHcy was analyzed. The influencing factors of poor prognosis in patients with acute ischemic stroke complicated with HHcy were analyzed, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum Chemerin and GAP-43 for poor prognosis in patients with acute ischemic stroke complicated with HHcy. Results:The levels of Chemerin and GAP-43 in the observation group were higher than those in the control group (all P<0.05). Serum Chemerin and GAP-43 levels in the severe group were higher than those in the mild group and the moderate group (all P<0.05), and serum Chemerin and GAP-43 levels in the moderate group were higher than those in the mild group (all P<0.05). Pearson correlation analysis showed that serum Chemerin and GAP-3 levels were positively correlated with the severity of acute ischemic stroke patients with HHcy ( r=0.458, 0.497, all P<0.05). Among 97 patients with acute ischemic stroke complicated with HHcy, 19 had poor prognosis and 78 had good prognosis. In the poor prognosis group, the proportion of diabetes, the severity of the disease and the levels of blood glucose, C-reactive protein (CRP), vascular endothelial growth factor (VEGF) and malondialdehyde (MDA) were higher than those in the good prognosis group (all P<0.05), and the superoxide dismutase (SOD) was lower than those in the good prognosis group ( P<0.05). Logistic regression analysis showed that the severity of the disease, CRP, Chemerin and GAP-43 were the influential factors for the poor prognosis of acute ischemic stroke patients with HHcy (all P<0.05). ROC curve results showed that the area under the curve (AUC) of serum Chemerin and GAP-43 levels and their combination in predicting poor prognosis of acute ischemic stroke patients with HHcy were 0.799, 0.804 and 0.907, respectively, and the AUC of the combination was larger ( P<0.05). Conclusions:Serum Chemerin and GAP-43 levels are closely related to the severity and prognosis of acute ischemic stroke patients with HHcy, and their combined value is higher in predicting poor prognosis.

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.
Adult ; Asian Continental Ancestry Group ; Biomarkers ; China ; Consensus ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Eosinophils ; Epidemiology ; Epigenomics ; Genetics ; Humans ; Hypersensitivity ; Inflammation ; International Agencies ; Medical Staff ; Neck ; Phenotype ; Precision Medicine

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.
Adult ; Asian Continental Ancestry Group* ; China ; Comorbidity ; Developed Countries ; Developing Countries ; Diagnosis* ; Epidemiologic Studies ; Epidemiology ; Global Health ; Humans ; Hypersensitivity* ; Prevalence ; Rhinitis, Allergic*

Objective: To explore the relationship between occupational stress and physiological and biochemical indexes, to research the health effect of the occupational stress in aircrew. Methods: 450 aircrews were conducted with the OSI-R questionnaire survey, examine the level of blood pressure, blood routine, ALT and UA. Results: The concentration of HB was positively related with task conflict and entertainment and leisure (β=0.262 and 0.106, both P<0.05) , while heavy task, task discomfort and psychological stress reactions were negatively related with HB (β=-0.163, -0.102, and -0.137, all P<0.05) ; task conflict and self-care were positively related with RBC (β=0.221 and 0.159, both P<0.01) , heavy task, psychological stress reactions and social support were negatively related with RBC (β=-0.157, -0.119, and -0.113, all P<0.05) ; task ambiguity and self-care had a positive relationship with ALT (β=0.144 and 0.159, both P<0.01) while heavy task, psychological stress reactions and social support had a negative relationship with ALT (β=-0.176, -0.096, and -0.102, all P<0.05) ; self-care was positively related with SBP (β=0.170, P<0.01) , task discomfort, interpersonal stress reactions and social support were negatively related with SBP (β=-0.093, -0.103, and -0.111, all P<0.05) ; while self-care was positively related with DBP (β=0.139, P<0.01) , social support was negatively related with DBP (β=-0.114, P<0.05) . Conclusion Occupational stress of the aircrew is significantly related with blood pressure, RBC, ALT and UA, occupational stress can make effects on the health of aircrew.

Objective To investigate the changes of microglia cell phenotypes in the injured brains of rats following repetitive mild traumatic brain injury (rmTBI).Methods Sixty male SD rats were randomly divided into sham-operated group,injury of one-week group,injury of two-week group,injury of four-week group,and injury of six-week group (n=12).Rats in the injury groups were induced rmTBI models by controlled cortical impact (CCI),and rats in the sham-operated group were only performed bone window opening without hitting.Six rats from each group were sacrificed;immunofluorescent staining was used to detect the Iba-1 positive microglial cells in the injured cortex and changes ofmicroglia subsets in the injured brain after rmTBI were analyzed by flow cytometry.Results As compared with the sham-operated group,the injury of one-week group and injury of six-week group had significantly increased percentages of Iba-1 positive microglial cells in the injured cortex (19％ and 12％,P＜0.05).flow cytometry indicated that CD451ow/CD11b+ cells were the microglial cells,accountting for 90％ ofCD11b+ cells;as compared with the sham-operated group,the injury of one-week group,injury of two-week group,injury of four-week group,and injury of six-week group had significantly increased M1 type microglial cells (P＜0.06),with injury of six-week group enjoying the highest level;as compared with the sham-operated group,the injury of one-week group,injury of two-week group and injury of four-week group had significantly increased M2 type microglial cells (P＜0.06),with injury of two-week group enjoying the highest level.Conclusion Dynamic changes ofmicroglia subsets after rmTBI are noted,which reveals that different subsets of microglia phenotypes might play their unique roles in the acute or chronic phases after rmTBI.

Objective To study the cognitive impairment in SD rats after intermittent hypoxia (IH),and explore the relation of miR-26b up-regulated expression and neuron apoptosis in the hippocampus of SD rats after IH.Methods Eight-week-old male SD rats (n=20,each weighing approximately 300±10 g) were randomly divided into normal oxygen control group,IH 1-week group,IH 2-weeks group and IH 4-weeks group (n=5).Rats in the later three groups were given IH for different times,and rats in the normal oxygen control group were given normal oxygen.The spatial learning and memory abilities were detected by Morris Water Maze (MWM) in the normal oxygen control group and IH 4-weeks group.The levels of apoptosis proteins Caspase3 and Bax and anti-apoptosis protein Bcl-2 in the hippocampus of 4 groups were detected by Western blotting.The miR-26b expression level in the 4 groups was detected by real time-PCR.Results (1) The results of MWM revealed that the mean escape latency in the IH 4-weeks group was significantly prolonged as compared with that in the normal oxygen control group (P＜0.05);the time entering into the target quadrant in the IH 4-weeks group ([22.0±6.7] s) was significantly shorter than that in the normal oxygen control group ([39.8±8.8] s,P＜0.05).(2) Western blotting indicated that up-regulated expressions of apoptosis proteins Bax and Casepase3 and down-regulated expression of anti-apoptosis protein Bcl-2 in the IH 1-week group,IH 2-weeks group and IH 4-weeks group were noted as compared with those in the control group,with significant differences (P＜0.05);significantly higher apoptosis protein Bax and Casepase3 expressions in the IH 1-week group were noted as compared with those in the IH 2-weeks group and IH 4-weeks group (P＜0.05),while significantly decreased Bcl-2 expression in the IH 1-week group was noted as compared with that in the IH 2-weeks group and IH 4-weeks group (P＜0.05).(3) The results of real time-PCR revealed that the miR-26b expression level in the hippocampus was up-regulated in the IH 1-week group,IH 2-weeks group and IH 4-weeks group as compared with that in the control group,with significant differences (P＜0.05);miR-26b expression level in the IH 1-week group was significantly higher as compared with that in the IH 2-weeks group and IH 4-weeks group (P＜0.05).Conclusion The miR-26b up-regulated expression in the hippocampus might refer to Bax /Bcl-2-related mitochondrial apoptotic signaling pathway after IH brain injury;miR-26b could be a potential mean ofgene therapy after IH brain injury.