Objective To identify children with high-risk systemic adverse reactions(SARs)associated with dust mite subcutaneous immunotherapy prior to immunotherapy.Methods An analysis was conducted on the high-risk factors in patients who experienced SARs prior to initial immunotherapy.A total of 40 pediatric patients with dust mite allergic rhinitis who underwent treatment with Dermatophagoides pteronyssinus(Dp)extracts at our hospital's pediatric department from April 2021 to January 2025 and developed SARs were selected as the observa-tion group,while 54 patients who did not experience SARs served as the control group.Differences in gender,age,disease duration,eosinophil count,polysensitization,multisystem involvement,total IgE(tIgE),and dust mite-specific IgE(sIgE)were evaluated.Results Significant differences were observed between the observation and control groups in polysensitization,multisystem involvement,and tIgE levels.The polysensitization rates were 70%vs.48.1%(P=0.034),multisystem involvement 55%vs.22.2%(P=0.001),and high tIgE levels(tIgE≥327.8 IU/mL)82.5%vs.62.1%(P=0.025).Multivariate logistic regression identified multisystem involvement[OR(95%CI)=4.278(1.749～10.461)]as an independent risk factor for SARs during allergen immunotherapy(AIT).Conclusion Patients with dust mite allergic rhinitis accompanied by multi-system damage exhibit poorer conventional prevention efficacy against SARs when undergoing AIT.They remain highly susceptible to SARs occur-rence,necessitating more robust preventive measures against SARs to enhance the safety of AIT.

Objective To identify children with high-risk systemic adverse reactions(SARs)associated with dust mite subcutaneous immunotherapy prior to immunotherapy.Methods An analysis was conducted on the high-risk factors in patients who experienced SARs prior to initial immunotherapy.A total of 40 pediatric patients with dust mite allergic rhinitis who underwent treatment with Dermatophagoides pteronyssinus(Dp)extracts at our hospital's pediatric department from April 2021 to January 2025 and developed SARs were selected as the observa-tion group,while 54 patients who did not experience SARs served as the control group.Differences in gender,age,disease duration,eosinophil count,polysensitization,multisystem involvement,total IgE(tIgE),and dust mite-specific IgE(sIgE)were evaluated.Results Significant differences were observed between the observation and control groups in polysensitization,multisystem involvement,and tIgE levels.The polysensitization rates were 70%vs.48.1%(P=0.034),multisystem involvement 55%vs.22.2%(P=0.001),and high tIgE levels(tIgE≥327.8 IU/mL)82.5%vs.62.1%(P=0.025).Multivariate logistic regression identified multisystem involvement[OR(95%CI)=4.278(1.749～10.461)]as an independent risk factor for SARs during allergen immunotherapy(AIT).Conclusion Patients with dust mite allergic rhinitis accompanied by multi-system damage exhibit poorer conventional prevention efficacy against SARs when undergoing AIT.They remain highly susceptible to SARs occur-rence,necessitating more robust preventive measures against SARs to enhance the safety of AIT.

As one of the important contents and links of doctor-patient communication, the quality of breaking bad news will affect the development of doctor-patient relationship. Bad news informed not only involves the feedback of clinical medical diagnosis results, but also involves special knowledge training and clinical experience accumulation, as well as ethical, legal, social custom and other factors. At present, it is still a difficult problem troubling physicians in the medical environment. From the different perspectives of doctors, patients and family members, this paper sorted out the domestic and international status of breaking bad news, revealed its internal dilemmas, and summarized the informing strategies to cope with these dilemmas, with a view to providing references for hospital managers and medical staff to earlier identify and properly inform, helping both doctors and patients to get rid of the dilemma of notification and improve the doctor-patient relationship.

Objective To analyze the characteristics of the muscle strength around the knee joint of chondromalacia patellae patients, and to explore the difference with normal people.Methods In March, 2021, 70 knee-onset chondromalacia patellae patients (experimental group) and 35 normal people (control group) were measured isokinetic muscle strength of flexion and extension of knee in angular velocities of 60°/s and 180°/s.Results At 60°/s and 180°/s, the peak torque, the peak torque-to-weight ratio and the total work of the flexor and extensor muscles on the affected side in the experimental group were lower than that of the control group (U > 1097.0, P<0.001). The peak torque, the peak torque-to-weight ratio and the total work of the flexor and extensor muscles at 60°/s and extensor muscles at 180°/s were lower on the affected side than on the healthy side in the experimental group (|Z| > 2.121, P<0.05). The peak torque ratios at 60°/s and 180°/s were more in the affected knees than in the healthy knees of experimental group and in the control group (U > 1810.0, |Z| >3.691, P<0.01).Conclusion The explosive force and endurance of the knee flexor and extensor has weakened in patients with chondromalacia patellae, and there is imbalance in knee joint muscle strength.

ObjectiveTo evaluate the reliability of Foot Posture Index (FPI-6) for Chinese adolescent idiopathic scoliosis (AIS) patients. MethodsFrom July, 2021 to April, 2022, 35 AIS patients were recruited from Guangdong Second Hospital of Traditional Chinese Medicine and non-specially. They were evaluated with FPI-6 by two raters on the same days, and by one of the raters a week later. The intra-class correlation coefficient (ICC) of inter-rater and test-retest was calculated and Bland-Altman diagram was drawn; the correlation among the items score and total score was analyzed with Spearman correlation coefficient. ResultsThe ICCs were above 0.75 except talar head palpation, and eversion and inversion of the calcaneus. There was no significant difference in foot posture classification among the three evaluation results (χ² = 4.000, P > 0.05). There was a significant positive correlation between each item score and total score (r > 0.3, P < 0.01). ConclusionFPI-6 is reliable for people with mild AIS.

Objective:To investigate the diagnostic value of MSCTP in Alzheimer's disease with sleep disorders as the primary manifestation.Methods:Seventy-six patients with Alzheimer's disease who had sleep disorders as the primary manifestation from January 2018 to December 2018 in the Seventh People's Hospital of Wenzhou were selected as study group, and 76 healthy subjects were selected as control group.Both two groups of subjects were diagnosed with MSCTP.The Pittsburgh sleep quality index(PQSI) score and the mini mental state examination (MMSE) score were compared between the two groups.The cerebral blood flow(CBF) was measured in the bilateral temporal lobe, frontal lobe, hippocampus and basal ganglia of the two groups.Results:The PQSI score of the study group[(9.42±0.60)points] was significantly higher than that of the control group[(2.87±0.17)points], the difference was statistically significant( t=11.379, P<0.05). The MMSE score of the study group[(16.54±1.19)points] was significantly lower than that of the control group[(27.49±0.82)points], the difference was statistically significant( t=9.637, P<0.05). The CBF of the left and right temporal lobe, frontal lobe, hippocampus and basal ganglia in the study group[left: (14.12±1.00)mL·min -1·100g -1, (18.40±1.29)mL·min -1·100g -1, (18.41±1.30) mL·min -1·100g -1, (31.90±11.41)mL·min -1·100g -1; right: (14.09±0.97)mL·min -1·100g -1, (18.42±1.02)mL·min -1·100g -1, (17.27±0.96)mL·min -1·100g -1, (15.48±6.28)mL·min -1·100g -1] were significantly lower than those in the control group[left: (19.30±1.12)mL·min -1·100g -1, (27.10±1.94)mL·min -1·100g -1, (27.13±1.42)mL·min -1·100g -1, (39.95±19.12)mL·min -1·100g -1; right: (19.32±1.11)mL·min -1·100g -1, (23.32±1.61)mL·min -1·100g -1, (22.18±1.00)mL·min -1·100g -1, (22.13±8.79)mL·min -1·100g -1], the differences were statistically significant( t=8.412, 8.469, 13.076, 4.763, 13.125, 5.183, 9.874, 7.376, all P<0.05). Conclusion:The sleep quality and cognitive ability of Alzheimer's disease patients with sleep disorders as the primary manifestation are poor, the diagnosis of MSCTP shows that CBF of patients are significantly reduced, which has certain value for clinical diagnosis.

Objective: To explore the clinical efficacy of ear acupuncture plus injection at Zusanli (ST 36) in treating shoulder pain after laparoscopic gynecological surgery, and to observe its effect on cytokines. Methods: Two hundred patients with shoulder pain after laparoscopic gynecological surgery were randomized into two groups based on their visiting sequence, 100 cases each. The observation group was intervened by ear acupuncture plus injection at Zusanli (ST 36), and the control group was intervened by oral administration of Ibuprofen, 10 d as a treatment course. The clinical efficacies of the two groups were compared after 2 treatment courses; the visual analogue scale (VAS), present pain intensity (PPI) and 36-item short-form health survey (SF-36) were measured before and after the treatment;the changes of interleukin (IL)-6 and IL-10 after the treatment were also observed. Results: The VAS and PPI scores were significantly changed after the treatment in both groups (both P<0.01). After the treatment, the VAS score in the observation group was significantly different from that in the control group (P<0.05). The component scores of SF-36 were significantly changed after the treatment in both groups (P<0.01); after the treatment, the scores of physical functioning (PF), bodily pain (BP), social functioning (SF), and mental health (MH) in the observation group were significantly different from those in the control group (all P<0.05). The contents of IL-6 and IL-10 dropped significantly after the intervention in both groups (both P<0.01), and the between-group differences were also statistically significant (both P<0.01). The total effective rate of the observation group was higher than that of the control group (P<0.05). Conclusion: Ear acupuncture plus injection at Zusanli (ST 36) can significantly improve the shoulder pain after laparoscopic gynecological surgery, down-regulate the expressions of IL-6 and IL-10, and boost the recovery.