Allergen specific immunotherapy（AIT）, as an effective treatment for allergic rhinitis, asthma, and other allergic diseases, has received widespread attention in the field of health economic evaluation in recent years. This article reviews the current status and progress of economic research on AIT, mainly discussing the socioeconomic burden of allergic rhinitis, the results of health economic studies from different countries, and the primary methods used in health economic research on allergic rhinitis. Existing studies indicate that, although AIT involves high initial costs, it offers significant long-term economic benefits by reducing healthcare resource utilization, improving patient quality of life, and decreasing medication dependence. Moreover, reducing initial costs, applying standardized assessment tools, and conducting cross-national comparative analyses have become key directions for future research. Overall, AIT demonstrates strong potential in terms of long-term health benefits and cost savings, providing solid economic evidence for the management of allergic diseases.
Humans ; Desensitization, Immunologic/economics* ; Cost-Benefit Analysis ; Rhinitis, Allergic/economics* ; Economics, Medical

Objective To investigate the situation of HIV infection and epidemiological characteristics among voluntary blood donors and pre-transfusion patients in Yuxi prefecture between 2010 and 2021.Methods Da-te collected with the HIV/AIDS Case Reporting Cards and original record of blood station,HIV antibody positive rate,the demographic characteristics,and epidemiological data of blood donors and pre-transfusion patients,were analyzed accordingly,the related date were statistically analyzed.Results The HIV antibody positive ratio were 5.56? and 2.01? among pre-transfusion patients and voluntary blood donors(P<0.001),showing an downward trend year after year.The HIV-positive detection rate among blood donors aged<25 years was significantly higher at 3.72‰ compared to 1.60‰ for those aged≥25 years(P=0.003).Among HIV-positive blood recipients,the proportion of individuals aged 15-24 years(34.62%)was markedly higher than that among blood donors(1.96%),whereas no donors were aged≥50 years compared to 23.53%of recipients(P<0.001).Farmers showed a significantly higher HIV detection rate(3.18‰)than students(2.66‰)and other occupations(1.60‰)(P=0.041).Similarly,individuals with high school education or below showed a higher detection rate(2.52‰)than those with high school education or above(1.45‰)(P=0.045).Among HIV-positive cases,blood donors had a higher proportion of HIV-infected individuals(84.62%)versus AIDS cases(15.38%),whereas the recipients showed the opposite trend:41.18%HIV-infected versus 58.82%AIDS cases(P<0.001).Conclusion In recent years,the HIV positive detection rate in Yuxi area has shown a downward trend,but the occurrence of HIV in Yuxi area is characterized by youthfulness and low education.Among them,HIV infected individuals through same-sex contact account for an important reason for HIV infection.

【Objective】 To achieve supervision and management of the whole business process of blood center, raise productivity and ensure blood quality by enabling blood center managers comprehensively grasp the key business operation situation of the whole process at anytime and anywhere. 【Methods】 A whole business process supervision and management system was established covering background of preparation, business scope, content of position supervision and management, overall framework design, interface design of management and supervision management, physical database design, program development and online debugging, and was integrated with the blood bank management information system. The display and management were through a mobile APP to record key indicators of business process from blood collection to blood supply timely and comprehensively. Statistical analysis was conducted on total collection volume, total preparation volume and total supply volume, as well as discarding rate of test unqualified and of non-test unqualified (lipemic blood excluded) in 2023 and 2022. 【Results】 We established a mobile APP based on a blood bank management information system for business supervision and management of whole process, and achieved management by phones. After its implementation in 2023, the total collection volume, total preparation volume and total supply volume in 2023 were all higher than those in 2022, with growth rates of 5.88% (13 247/225 454 U), 4.73% (24 156/510 698 U), and 6.70% (34 814/519 914 U), respectively. The discarding rate in 2023 was lower than that in 2022 (0.54%, 2 868/534 854 U) vs (0.60%, 3 047/510 698 U) (P<0.01), and the non-test unqualified discarding rate (lipemic blood excluded) in 2023 was significantly lower than that in 2022(0.12%, 649/534 854 U) vs (0.19%, 991/510 698 U)(P<0.01). 【Conclusion】 The construction of supervision and management system of a whole business process based on blood bank management information system can meet the standardized service needs of managers at anytime and anywhere, continuously raise productivity and the standardization and scientific level of blood bank management, thus ensuring blood supply.

Objective:To explore the effects of conflicting stimuli generated by different chromatic lights on visual display terminal (VDT) on accommodative response and microfluctuation of myopes and emmetropes, and to investigate the possible relationship between chromatic light, accommodation and the development and progression of myopia.Methods:A non-randomized controlled trial was conducted.Forty-one subjects aged 22 to 30 years old were enrolled, including 19 emmetropes in emmetropic group and 22 myopes in myopic group.The subjects had the normal color vision and no ocular organic diseases.The interventions were screens of different colors.There were 7 chromatic light conditions, including 3 monochromatic lights (red, green, blue), 3 bichromatic lights (red+ green, red+ blue, green+ blue) and 1 polychromatic light (white=red+ green+ blue). Subjects were asked to look at a black E target on a VDT at a distance of 33 cm for more than 20 seconds.The background color of the VDT was changed randomly in the 7 chromatic light conditions.The accommodative responses were recorded with the Grand Seiko WAM-5500 automatic infrared refractor every 0.2 seconds and the accommodative microfluctuation was calculated as the standard deviation of the accommodative response.Accommodative response and accommodative microfluctuation under different chromatic light conditions were compared.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the First Affiliated Hospital, Zhejiang University School of Medicine (No.2019-1564). Written informed consent was obtained from each subject.Results:No statistically significant difference was found in the accommodative response between the two groups ( Fgroup=2.626, P=0.113). There was a statistically significant difference under different chromatic light conditions between the two groups ( Flight=39.070, P<0.01). There were similar trends in the effects of various color lights in both groups, with the largest accommodative response under monochromatic red light, followed by the bichromatic light containing red light, and then the smallest accommodative response under monochromatic blue light, and the differences were statistically significant (all at P<0.05). The accommodative microfluctuations under red, green, blue, red+ blue, red+ green, blue+ green and white light conditions were (0.142±0.033), (0.128±0.038), (0.131±0.043), (0.139±0.039), (0.127±0.034), (0.131±0.043) and (0.139±0.042)D in emmetropic group, and (0.178±0.043), (0.164±0.043), (0.159±0.039), (0.174±0.042), (0.166±0.036), (0.159±0.031) and (0.174±0.035)D in myopic group, respectively, showing statistically significant differences between them ( Fgroup=12.146, P<0.01; Flight=2.782, P<0.05). The accommodative microfluctuations under the 7 light conditions were higher in myopic group than in emmetropic group, and the differences were statistically significant (all at P<0.05). In myopes, the accommodative microfluctuation was the largest under red light, which was significantly larger than that under blue light, and was the smallest under blue+ green light (all at P<0.05). There was no significant difference in the accommodative microfluctuation between bichromatic light and its two monochromatic lights, or between the polychromatic light (white light) and its three monochromatic lights (all at P>0.05). There was no significant effect of various chromatic lights on the accommodative microfluctuation in emmetropic group (all at P>0.05). Conclusions:The accommodative microfluctuation is greater in myopes than in emmetropes.The stimuli produced by long-wavelength light cause larger accommodative microfluctuation, while conflicting stimuli generated by different chromatic lights do not increase accommodative microfluctuation.

Objective:To systematically review the teaching effect of problem-based learning (PBL) combined with evidence-based medicine (EBM) teaching mode on the standardized residency training.Methods:CNKI, Wanfang database, VIP database, SinoMed, Embase, PubMed and Web of SCI databases were searched, and the randomized controlled trial (RCT) studies of the application of EBM combined with PBL teaching in standardized residency training were collected. The retrieval time was from the establishment to 1st July, 2018. Two investigators independently extracted data and assessed the quality of the studies. After assessing the risk of bias of included studies, Meta-analysis was performed on RevMan 5.3.Results:In total, 4 studies were included in the review. Narrative assessment was adopted, because outcome indicators of these study were varied and the quality of the literatures could not meet the requirement of Meta-analysis. Our study suggested that the residents who were in PBL combined with EBM teaching mode group got higher scores in the standardized residency training, compared with those in the lecture-based learning (LBL) teaching mode group, especially in case analysis score, total score of examination, improvement of clinical thinking ability, communication and expression ability, organization and cooperation ability, etc.Conclusion:The current evidence suggests that the application of EBM combined with PBL teaching mode has a positive effect on the standardized residency training. Compared with the traditional LBL teaching, EBM can improve students' ability. However, limited by the quantity and quality of included studies, the above conclusions still need to be verified by more studies with larger samples and higher quality.

Objective:To explore the performance of the commonly used whole blood C-reactive protein (CRP) detection systems and give related recommendation on the performance requirements of detection systems.Methods:A total of 7 540 venous blood samples from 26 maternal, child and children′s hospitals were collected to conduct this multi-center study on the analytical performance of 5 commonly used whole blood CRP detection systems from March to April in 2019. The blank check, carryover, repeatability, intermediate precision, linearity, sample stability, influence of hematocrit/triglyceride/bilirubin, comparison with SIEMENS specific protein analyzer and trueness were evaluated. The 5 systems included BC-5390CRP autohematology analyzer, AstepPLUS specific protein analyzer, Ottoman-1000 Automated Specific Protein POCT Workstation, i-CHROMA Immunofluorometer equipment Reader and Orion QuikRead go detecting instrument. The 5 systems were labeled as a, b, c, d and e randomly.Results:Within the 5 systems, all values of blank check were less than 1.00 mg/L, the carryovers were lower than 1.00%. The repeatability of different ranges of CRP concentrations including 3.00-10.00, 10.00-30.00 and>30.00 mg/L were less than 10.00%, 6.00% and 5.00%, respectively, and the intermediate precision was less than 10.00%. The linearity correlation coefficients of the 5 systems were all above 0.975, while the slope was within 0.950-1.050. Whole blood samples were stable within 72 hours both at room temperature (18-25 ℃) and refrigerated temperature (2-8 ℃). The CRP results were rarely influenced by high triglyceride or bilirubin, except for the immmunoturbidimetric test based on microparticles coated with anti-human CRP F(ab) 2 fragments. When triglyceride was less than 15.46 mmol/L, the deviation of CRP was less than 10.00%. When bilirubin was less than 345.47 μmol/L, the deviation of CRP was less than 10.00%. CRP was more susceptible to Hct on the systems without Hct correction. The deviation of CRP between different Hct dilution concentration and 40% dilution concentration can reach as high as 67.48%. The correlation coefficients ( r) of 5 systems were all more than 0.975 in the range of 0-300.00 mg/L compared with Siemens specific protein analyzer. All systems passed the trueness verification using the samples with specified values of 12.89 and 30.60 mg/L. Conclusion:The performance of 5 systems can basically meet the clinical needs, but it is suggested that the whole blood CRP detection system without automatic Hct correction should be modified manually.

Objective: To assess the effectiveness in optimizing resources and shortening critical children′s waiting time in pediatric emergency department (PED) with five-level pediatric emergency triage system (PETS). Methods: This retrospective study was conducted in the First Affiliated Hospital of Xiamen University after PETS was applied. The data of patients who visited the pediatric emergency department from January 2015 to December 2017 were collected and analyzed, including age, sex, diseases, visiting time, triage rate and destination. Results: A total of 375 985 patients were included, among whom males were 225 308 (59.9%) and females were 150 677 (40.1%), all younger than 14 years of age. The number of critical cases (level Ⅰ, level Ⅱ and level Ⅲ) was increased from 4 719 (3.7%) in 2015, 12 209 (10.2%) in 2016 to 16 188 (12.7%) in 2017. The number of non-critical patients (level Ⅴ) decreased year by year, as from 98 213 (76.8%) in 2015 to 75 210 (62.6%) in 2016 and 78 857 (61.7%) in 2017. The patients who classified as level Ⅰ or levelⅡaccording to the PETS were seen immediately by physician (n=1855, 0.5%). Overall, 119 738 patients (98.3%) who were classified as level Ⅲ or level Ⅳ could be seen by physician in a timely manner according to triage guidelines, while 2 112 patients (1.7%) could not. The mean waiting time was 9.09 min in level Ⅲ, 17.7 min in level Ⅳ, and 55.76 min in level Ⅴ patients, respectively. The critical cases admitted to the intensive care units were 175 (36.2%) in 2015, 350 (62.8%) in 2016 and 374 (66.2%) in 2017. The etiologies were respiratory diseases (73.3%), gastrointestinal diseases (15.8%) and infectious diseases (3.1%). Conclusion The application of PETS could optimize emergency resources and shorten the waiting time of critically ill children.

course of Internal Medicine and Surgery Nursing. Methods From September 2014 to July 2016, the Grade 2013 nursing students at the Sino American cooperative nursing class in the Nursing College of Wenzhou Medical University were selected as the experimental group by convenient sampling method, with a total of 59 people. The Grade 2012 nursing students in the Sino American cooperative nursing class were selected as the control group, with a total of 60 people. The nursing students in the control group received traditional teaching methods and the nursing students in the experimental group received the self participating teaching method. We compared students' self-learning ability, theoretical knowledge and comprehensive practical ability between the two groups. Results The total score of self-learning ability and the scores of all dimensions of experimental group were higher than those in the control group after class, and the differences were statistically significant (P< 0.05). The scores of theoretical knowledge and comprehensive practice ability of the experimental group were higher than those of the control group, and the differences were statistically significant (P< 0.05). Conclusions Self participation teaching method is a teaching method that helps teachers play a leading role in giving play to students' main body status. It helps to promote the development of nursing students' independent learning ability, and improve their theoretical level and nursing practice ability.

[Adstract] Micro-lecture, as the main teaching form of MOOC and SPOC network teaching platform, is deeply welcomed by the majority of students. Pathology is the bridge connecting basic medicine and clin-ical medicine in medical education, which has such characteristics as many knowledge points, dispersion and obscurity, etc. Therefore, the production of micro courses is based on the knowledge points, and according to the characteristics of the knowledge points, it should also be applied reasonably according to the charac-teristics of each chapter. Adopting the teaching of self-study after class and teachers and students' discussion in class for micro courses can not only greatly improve the quality of teaching, but also develop the students' ability of independent thinking and the ability to analyze and solve problems, which transforms the teaching of pathology from pure knowledge to ability.

Objective To explore the clinical teaching intervention measure and effect of the cultivation of humanistic quality of post 90s nursing students in practice .Methods One hundred and forty-eight nursing students in practice from 2012 and 152 cases from 2013 were chosen and divided into the control group and the observation group .The control group received traditional way of teaching , the observation group received the intervention study on the cultivation of humanistic quality about ten months through the bucket theory .The comprehensive intervention measures were carried out through the way of joint teaching in all clinical departments so as to improve the teaching philosophy , update the concepts of education , reform the curriculum structure, optimize teaching contents , refine teaching processes , and strengthen the model and guidance .The evaluation was carried out according to the formulation of methods and standard of evaluating the humanistic quality and professional image of nursing students in practice , and the scores of evaluation were analyzed , and the interventional effect was compared .Results The cases of nursing students in practice who respectively got 10-20, 21-30, and 31-40 were 4 cases (2.6%), 49 cases (32.3%), 99 cases (65.1%) in the observation group, and were significantly higher than 22 cases (14.9%), 53 cases (35.8%), 73 cases (49.3%) in the control group, and the difference was statistically significant (Z=-3.351, P<0.05).The score of hospital patients on the cultivation of humanistic quality and self-evaluation of nursing students in practice in the observation group were higher than those in the control group , and the difference was statistically significant (Z=-3.202, P <0.05 ).Conclusions The implementation of the intervention of the cultivation of humanistic quality through the bucket theory can effectively improve the nursing students ’ humanistic quality , improve the professional image , and is benefit to all-round development of the nursing students in practice .