Objective:To construct a diagnostic prediction model for childhood asthma and conduct a preliminary evaluation based on the test results of specific IgE (sIgE) for airborne allergens and in combination with clinical data.Methods:This study is a case-control study. A total of 4 338 cases that completed the sIgE test for airborne allergens in the Allergy Department of Beijing Children′s Hospital Affiliated to Capital Medical University from January to December 2023 were selected as the research subjects. They were divided into the asthma group and the non-asthma group based on the diagnostic information. Age, gender, cough and wheezing symptoms, and the classification results of sIgE concentrations of 15 airborne allergens were collected as the predictor variables of the asthma diagnostic prediction model. Differential analysis and LASSO regression were employed for the screening of predictor variables. The multivariate logistic regression method was applied to construct the nomogram prediction model. The data set was randomly split at a ratio of 7∶3 into a training set (3 036 cases) for constructing the prediction model and a validation set (1 302 cases) for testing the predictive efficacy of the model. The area under the receiver operating characteristic (ROC) curve (AUC), the Hosmer-Lemeshow calibration curve were utilized to assess the discrimination and goodness of fit of the model, and the clinical decision curve (DCA) was adopted to evaluate the clinical application value of the model.Results:Among 4 338 pediatric cases, children aged 0 to <3 years accounted for 10.17% (441 cases), those aged 3 to <6 years accounted for 36.49% (1 583 cases), those aged 6 to <12 years accounted for 46.98% (2 038 cases), and those aged 12 to 18 years accounted for 6.36% (276 cases). Males constituted 65.17% (2 827 cases), and females 34.83% (1 511 cases). The proportion of children without wheezing symptoms was 41.47% (1 799 cases), while those with wheezing symptoms was 58.53% (2 539 cases). The asthma group accounted for 41.77% (1 812 cases), and the non-asthma group for 58.23% (2 526 cases). Statistically significant differences were observed between the asthma group and the non-asthma group in 18 predictive variables including age, gender, wheezing symptoms, d1, d2, e1, e5, g2, g6, m6, t11, t3, t6, w1, w22, w6, wx5, and m3 ( P<0.05). LASSO regression analysis identified six predictor variables: age (calculated in months), cough and wheezing symptoms, and sIgE of four airborne allergens, namely, Dermatophagoides pteronyssinus (d1), Canis familiaris dander (e5), Aspergillus fumigatus (m3), and Artemisia vulgaris pollen (w6).Multifactorial regression analysis revealed that the contribution degrees of the above-mentioned predictor variables to the asthma diagnosis prediction model were ranked as follows: cough and wheezing symptoms ( OR=24.37, P<0.001), m3 ( OR=1.34, P<0.001), d1 ( OR=1.22, P<0.001), e5 ( OR=1.12, P=0.028), w6 ( OR=1.11, P<0.001), and age ( OR=1.01, P<0.001).The AUCs of the nomogram prediction model for the training set and the validation set were 0.853 (95% CI: 0.840-0.866) and 0.838 (95% CI: 0.817-0.860), respectively. The Hosmer-Lemeshow calibration curve indicated a good fit ( P=0.215 for the training set; P=0.352 for the validation set). The DCA of the validation set demonstrated that when the probability threshold for predicting the occurrence of childhood asthma was 8%-92%, the model had the best applicability. Conclusion:By combining age, cough and wheezing symptoms, and sIgE of the four airborne allergens (d1, e5, m3, and w6) selected from 15 airborne allergens, a childhood asthma diagnosis prediction model with good predictive performance and clinical practicability was constructed. It can serve as a simple and convenient tool for accurately identifying asthma and provides a practical basis for the application of artificial intelligence big data analysis models in the prevention, treatment, and management of childhood asthma.

BACKGROUND:The use of exosomes as drug carriers can not only precisely target the therapeutic site,but also increase the local concentration,opening up a new way for drugs to enter the central nervous system.OBJECTIVE:To explore the biogenesis and biological functions of exosomes and summarize the current state-of-the-art regarding extracellular vesicles as drug carriers in the treatment of central nervous system diseases.METHODS:The first author searched Web of Science,PubMed,and CNKI for relevant literature from January 1976 to January 2024.The English search terms were"exosomes,extracellular vesicles,central nervous system,drug delivery,ischemic stroke,Alzheimer's disease,Parkinson's disease,spinal cord injury,brain tumor."The Chinese search terms were"exosomes,extracellular vesicles,central nervous system diseases,drug delivery,stroke,Alzheimer's disease,Parkinson's disease,spinal cord injury,brain tumor."Finally,94 articles were included for analysis.RESULTS AND CONCLUSION:(1)Exosomes can easily cross the blood-brain barrier and deliver proteins,metabolites,and nucleic acids to recipient cells to regulate cellular metabolism.Since exosomes are small vesicles secreted by cells,they have a much lower circulating immunogenicity and can be less likely to be recognized and cleared by macrophages in the internal circulation.(2)Exosomes can be engineered to deliver different therapeutically ingredients,including RNA,proteins,chemotherapeutic drugs,and immunomodulators,and are capable of delivering them to the desired target areas.Engineered modified exosomes have better targeting properties.Furthermore,this exosome-mediated delivery is extremely low in immunogenicity and is expected to provide a safer and more effective method for precision therapy of central nervous system diseases in the future.

Objective:To analyze the distribution of allergen components of dust mite in children with airway allergic diseases.Methods:This was a cross-sectional study. The clinical data of children with dust mite-induced allergic asthma (AA) complicated with allergic rhinitis (AR) or allergic rhinitis who were treated in Department of Allergy,Beijing Children′s Hospital from January 2019 to October 2022 were retrospectively analyzed. The spedific IgE (sIgE) levels to Der p1,Der p2,Der p5,Der p7,Der p10,Der p21,Der p23 and Der f1,Der f2 were detected by protein chip method. The distribution of dust mite sensitized components and the sIgE levels in children with different airway allergic diseases and different ages were compared.Results:Among 138 children with airway allergic diseases,there were 97 boys and 41 girls,age (6.86±2.61) years old,and there were 106 cases of AA combined AR (AAAR group) and 32 cases of AR alone (AR group). The sensitization rates of Der p2 was the highest (75.4%,104/138),followed by Der f2 (74.6%,103/138),Der f1 (73.9%,102/138),Der p1 (71.7%,99/138),Der p21 (19.6%,27/138),Der p5 (16.7%,23/138),Der p23 (14.5%,20/138),Der p7 (11.6%,16/138) and Der p10 (2.9%,4/138). The co-sensitization rate of Der p1,Der p2,Der f1 and Der f2 was the highest (31.2%,43/138). There was no significant difference in sensitization rate of dust mites components between AAAR group and AR group(all P>0.05). AAAR group had higher levels of sIgE to Der p23 than AR group [0.1 (0,0.1) IU/ml vs. 0 (0,0.1) IU/ml,Z=-2.819, P=0.005]. There were no significant differences in the positive rate of dust mite components and sIgE levels between children aged≤6 and>6 years old with airway allergic diseases(all P>0.05). Conclusions:Der p1,Der p2,Der f1 and Der f2 are the major components of dust mites sensitizing airway allergic diseases in children. Der p1,Der p2,Der f1 and Der f2 are the main co-sensitizing components in children with dust mite-induced airway allergic diseases. Compared with AR,the sIgE level to Der p23 in children with AAAR is higher.

Objective:To construct a diagnostic prediction model for childhood asthma and conduct a preliminary evaluation based on the test results of specific IgE (sIgE) for airborne allergens and in combination with clinical data.Methods:This study is a case-control study. A total of 4 338 cases that completed the sIgE test for airborne allergens in the Allergy Department of Beijing Children′s Hospital Affiliated to Capital Medical University from January to December 2023 were selected as the research subjects. They were divided into the asthma group and the non-asthma group based on the diagnostic information. Age, gender, cough and wheezing symptoms, and the classification results of sIgE concentrations of 15 airborne allergens were collected as the predictor variables of the asthma diagnostic prediction model. Differential analysis and LASSO regression were employed for the screening of predictor variables. The multivariate logistic regression method was applied to construct the nomogram prediction model. The data set was randomly split at a ratio of 7∶3 into a training set (3 036 cases) for constructing the prediction model and a validation set (1 302 cases) for testing the predictive efficacy of the model. The area under the receiver operating characteristic (ROC) curve (AUC), the Hosmer-Lemeshow calibration curve were utilized to assess the discrimination and goodness of fit of the model, and the clinical decision curve (DCA) was adopted to evaluate the clinical application value of the model.Results:Among 4 338 pediatric cases, children aged 0 to <3 years accounted for 10.17% (441 cases), those aged 3 to <6 years accounted for 36.49% (1 583 cases), those aged 6 to <12 years accounted for 46.98% (2 038 cases), and those aged 12 to 18 years accounted for 6.36% (276 cases). Males constituted 65.17% (2 827 cases), and females 34.83% (1 511 cases). The proportion of children without wheezing symptoms was 41.47% (1 799 cases), while those with wheezing symptoms was 58.53% (2 539 cases). The asthma group accounted for 41.77% (1 812 cases), and the non-asthma group for 58.23% (2 526 cases). Statistically significant differences were observed between the asthma group and the non-asthma group in 18 predictive variables including age, gender, wheezing symptoms, d1, d2, e1, e5, g2, g6, m6, t11, t3, t6, w1, w22, w6, wx5, and m3 ( P<0.05). LASSO regression analysis identified six predictor variables: age (calculated in months), cough and wheezing symptoms, and sIgE of four airborne allergens, namely, Dermatophagoides pteronyssinus (d1), Canis familiaris dander (e5), Aspergillus fumigatus (m3), and Artemisia vulgaris pollen (w6).Multifactorial regression analysis revealed that the contribution degrees of the above-mentioned predictor variables to the asthma diagnosis prediction model were ranked as follows: cough and wheezing symptoms ( OR=24.37, P<0.001), m3 ( OR=1.34, P<0.001), d1 ( OR=1.22, P<0.001), e5 ( OR=1.12, P=0.028), w6 ( OR=1.11, P<0.001), and age ( OR=1.01, P<0.001).The AUCs of the nomogram prediction model for the training set and the validation set were 0.853 (95% CI: 0.840-0.866) and 0.838 (95% CI: 0.817-0.860), respectively. The Hosmer-Lemeshow calibration curve indicated a good fit ( P=0.215 for the training set; P=0.352 for the validation set). The DCA of the validation set demonstrated that when the probability threshold for predicting the occurrence of childhood asthma was 8%-92%, the model had the best applicability. Conclusion:By combining age, cough and wheezing symptoms, and sIgE of the four airborne allergens (d1, e5, m3, and w6) selected from 15 airborne allergens, a childhood asthma diagnosis prediction model with good predictive performance and clinical practicability was constructed. It can serve as a simple and convenient tool for accurately identifying asthma and provides a practical basis for the application of artificial intelligence big data analysis models in the prevention, treatment, and management of childhood asthma.

BACKGROUND:The use of exosomes as drug carriers can not only precisely target the therapeutic site,but also increase the local concentration,opening up a new way for drugs to enter the central nervous system.OBJECTIVE:To explore the biogenesis and biological functions of exosomes and summarize the current state-of-the-art regarding extracellular vesicles as drug carriers in the treatment of central nervous system diseases.METHODS:The first author searched Web of Science,PubMed,and CNKI for relevant literature from January 1976 to January 2024.The English search terms were"exosomes,extracellular vesicles,central nervous system,drug delivery,ischemic stroke,Alzheimer's disease,Parkinson's disease,spinal cord injury,brain tumor."The Chinese search terms were"exosomes,extracellular vesicles,central nervous system diseases,drug delivery,stroke,Alzheimer's disease,Parkinson's disease,spinal cord injury,brain tumor."Finally,94 articles were included for analysis.RESULTS AND CONCLUSION:(1)Exosomes can easily cross the blood-brain barrier and deliver proteins,metabolites,and nucleic acids to recipient cells to regulate cellular metabolism.Since exosomes are small vesicles secreted by cells,they have a much lower circulating immunogenicity and can be less likely to be recognized and cleared by macrophages in the internal circulation.(2)Exosomes can be engineered to deliver different therapeutically ingredients,including RNA,proteins,chemotherapeutic drugs,and immunomodulators,and are capable of delivering them to the desired target areas.Engineered modified exosomes have better targeting properties.Furthermore,this exosome-mediated delivery is extremely low in immunogenicity and is expected to provide a safer and more effective method for precision therapy of central nervous system diseases in the future.

Objective:To analyze the distribution of allergen components of dust mite in children with airway allergic diseases.Methods:This was a cross-sectional study. The clinical data of children with dust mite-induced allergic asthma (AA) complicated with allergic rhinitis (AR) or allergic rhinitis who were treated in Department of Allergy,Beijing Children′s Hospital from January 2019 to October 2022 were retrospectively analyzed. The spedific IgE (sIgE) levels to Der p1,Der p2,Der p5,Der p7,Der p10,Der p21,Der p23 and Der f1,Der f2 were detected by protein chip method. The distribution of dust mite sensitized components and the sIgE levels in children with different airway allergic diseases and different ages were compared.Results:Among 138 children with airway allergic diseases,there were 97 boys and 41 girls,age (6.86±2.61) years old,and there were 106 cases of AA combined AR (AAAR group) and 32 cases of AR alone (AR group). The sensitization rates of Der p2 was the highest (75.4%,104/138),followed by Der f2 (74.6%,103/138),Der f1 (73.9%,102/138),Der p1 (71.7%,99/138),Der p21 (19.6%,27/138),Der p5 (16.7%,23/138),Der p23 (14.5%,20/138),Der p7 (11.6%,16/138) and Der p10 (2.9%,4/138). The co-sensitization rate of Der p1,Der p2,Der f1 and Der f2 was the highest (31.2%,43/138). There was no significant difference in sensitization rate of dust mites components between AAAR group and AR group(all P>0.05). AAAR group had higher levels of sIgE to Der p23 than AR group [0.1 (0,0.1) IU/ml vs. 0 (0,0.1) IU/ml,Z=-2.819, P=0.005]. There were no significant differences in the positive rate of dust mite components and sIgE levels between children aged≤6 and>6 years old with airway allergic diseases(all P>0.05). Conclusions:Der p1,Der p2,Der f1 and Der f2 are the major components of dust mites sensitizing airway allergic diseases in children. Der p1,Der p2,Der f1 and Der f2 are the main co-sensitizing components in children with dust mite-induced airway allergic diseases. Compared with AR,the sIgE level to Der p23 in children with AAAR is higher.

Objective:This study aimed to analyze the test results and changing trend of specific IgE (sIgE) for common allergens in children in the hospital from 2019 to 2023, so as to provide a basis for the diagnosis and treatment of allergic diseases in children.Methods:The test results of children who were admitted to Beijing Children′s Hospital, Capital Medical University and underwent serum allergen sIgE quantitative detection (Immuno CAP system) from January 1, 2019 to December 31, 2023 were retrospectively included. According to the allergen type, the allergens were divided into food allergens and inhaled allergens (dust mite group, mold group, animal dander group and pollen group). The trends in sIgE positive rates across different years, age-related differences, and monthly distribution characteristics were analyzed.Results:A total of 44 633 allergen sIgE quantitative test results were included in the study. Among them, 23 024 samples were tested for food allergen sIgE and 21 609 samples were tested for inhaled allergen sIgE. The positive rates of food allergens (egg white, milk, wheat, peanut, soybean, shrimp) sIgE increased year by year, and the differences were statistically significant ( χ2=97.3, 78.9, 95.6, 122.4, 84.7, 24.5, P<0.001). The positive rate of inhaled allergen sIgE also increased year by year, and the difference was statistically significant ( χ2=36.2, 326.2, 432.2, 973.2, P<0.001). There were significant differences in the sensitization patterns of food and inhaled allergens among different age groups. The most common food allergen was egg white in infant group (<1 year old) (23.0%), milk in young children group (1-2 years old) (40.7%), and egg white in preschool group (3-6 years old) (28.8%). Peanut was the most common allergen in school-age group (7-12 years old) and adolescent group (13-18 years old) (16.9% and 14.1%, respectively). Among the inhaled allergens, animal dander (3.6%) was the most common allergen in the infant group (<1 year old), and mold (15.3%) was the most common allergen in the young child group (1-2 years old). The most common allergens in preschool group (3-6 years old), school-age group (7-12 years old) and adolescent group (13-18 years old) were pollen (39.7%, 53.0%, 53.5%). There were significant differences in the positive rates of inhaled allergens (dust mite, mold, animal dander, pollen) sIgE in the 12 months of 2023 ( χ2=26.9, 26.7, 56.7, 55.5, P=0.005, 0.005,<0.001,<0.001). The positive rate of pollen sIgE was the highest, with peaks in April (54.8%) and September (60.5%). The positive rate of sIgE for molds peaks in June (46.4%). Conclusion:The trends in sIgE levels among children visiting Beijing Children′s Hospital, Capital Medical University, from 2019 to 2023, suggests to a certain extent that the prevalence of allergic diseases among children in Beijing City is increasing annually. There were significant age differences in sIgE sensitization patterns among children of different ages, and the distribution of sIgE positive rates for inhaled allergens was also different in different months. In clinical practice, the allergen test report is interpreted comprehensively according to the patient′s medical history, age, visit month and other factors.

To clarify the genetic diversity and structure of the nucleus population of F1-generation Litopenaeus vannamei, this study utilized 15 pairs of highly polymorphic microsatellite primers to analyze the simple sequence repeat (SSR) markers and genetic diversity in 15 full-sib families of L. vannamei. A total of 112 alleles (N_a) and 60.453 effective alleles (N_e) were identified among the selected 15 SSR loci, with the average polymorphic information content (PIC) of 0.648. The average N_e, observed heterozygosity (H_o), and expected heterozygosity (H_e) in the 15 F1 families varied from 1.925 to 2.626, 0.425 to 0.783, and 0.403 to 0.572, respectively. The 15 full-sib families were primarily clustered into three categories in the phylogenetic analysis, with the genetic distance between families ranging from 0.252 to 0.574. Additionally, the genetic differentiation coefficient (F_st) among the families varied from 0.112 to 0.278, indicating substantial genetic differentiation. Overall, this study suggested that the genetic diversity of the 15 full-sib families was moderate, providing valuable genetic insights for the subsequent breeding initiatives aimed at enhancing the tolerance of L. vannamei to high levels of soybean meal.
Penaeidae/classification* ; Microsatellite Repeats/genetics* ; Animals ; Genetic Variation ; Polymorphism, Genetic ; Phylogeny ; Alleles ; Genetic Markers

Objective:This study aimed to analyze the test results and changing trend of specific IgE (sIgE) for common allergens in children in the hospital from 2019 to 2023, so as to provide a basis for the diagnosis and treatment of allergic diseases in children.Methods:The test results of children who were admitted to Beijing Children′s Hospital, Capital Medical University and underwent serum allergen sIgE quantitative detection (Immuno CAP system) from January 1, 2019 to December 31, 2023 were retrospectively included. According to the allergen type, the allergens were divided into food allergens and inhaled allergens (dust mite group, mold group, animal dander group and pollen group). The trends in sIgE positive rates across different years, age-related differences, and monthly distribution characteristics were analyzed.Results:A total of 44 633 allergen sIgE quantitative test results were included in the study. Among them, 23 024 samples were tested for food allergen sIgE and 21 609 samples were tested for inhaled allergen sIgE. The positive rates of food allergens (egg white, milk, wheat, peanut, soybean, shrimp) sIgE increased year by year, and the differences were statistically significant ( χ2=97.3, 78.9, 95.6, 122.4, 84.7, 24.5, P<0.001). The positive rate of inhaled allergen sIgE also increased year by year, and the difference was statistically significant ( χ2=36.2, 326.2, 432.2, 973.2, P<0.001). There were significant differences in the sensitization patterns of food and inhaled allergens among different age groups. The most common food allergen was egg white in infant group (<1 year old) (23.0%), milk in young children group (1-2 years old) (40.7%), and egg white in preschool group (3-6 years old) (28.8%). Peanut was the most common allergen in school-age group (7-12 years old) and adolescent group (13-18 years old) (16.9% and 14.1%, respectively). Among the inhaled allergens, animal dander (3.6%) was the most common allergen in the infant group (<1 year old), and mold (15.3%) was the most common allergen in the young child group (1-2 years old). The most common allergens in preschool group (3-6 years old), school-age group (7-12 years old) and adolescent group (13-18 years old) were pollen (39.7%, 53.0%, 53.5%). There were significant differences in the positive rates of inhaled allergens (dust mite, mold, animal dander, pollen) sIgE in the 12 months of 2023 ( χ2=26.9, 26.7, 56.7, 55.5, P=0.005, 0.005,<0.001,<0.001). The positive rate of pollen sIgE was the highest, with peaks in April (54.8%) and September (60.5%). The positive rate of sIgE for molds peaks in June (46.4%). Conclusion:The trends in sIgE levels among children visiting Beijing Children′s Hospital, Capital Medical University, from 2019 to 2023, suggests to a certain extent that the prevalence of allergic diseases among children in Beijing City is increasing annually. There were significant age differences in sIgE sensitization patterns among children of different ages, and the distribution of sIgE positive rates for inhaled allergens was also different in different months. In clinical practice, the allergen test report is interpreted comprehensively according to the patient′s medical history, age, visit month and other factors.

Objective:Glucorticoid therapy has the potential to mitigate immunogical effect of naxitamab. Ketamine is an anesthetic medica-tion and cause weak or shallow breathing. This article is to analyze the effect of modified conditioning regimen with substitution re-mifentanil for ketamine and without glucorticoid therapy on adverse events associated with naxitamab. Methods:Clinical data with naxit-amab infusion under modified conditioning regimen in Sun Yat-sen University Cancer Center between June 2023 and June 2024 were re-trieved to analyze adverse events and risk factors. Results:Overall,seventeen patients underwent 201 infusions. The most frequent adverse events were as follows:neurological pain (all grades) 93.0％,hypertension 55.7％,hypotension 34.8％,respectively. Bronchospasm and hyp-oxia were seen in 3.0％ and 10.9％ infusions,respectively. Fever occurred less frequently in the second cycle of infusion. No patients suspen-ded infusion due to severe adverse event. Conclusions:The infusion of naxitamab is tolerable under the modified conditioning regimen and adverse event is less than expected and controllable.