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Objective:To determine the causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema using Mendelian randomization (MR) analyses.Methods:This study was a secondary data analysis based on the summary data of genome-wide association studies (GWAS), which involved 293 723 participants (educational attainment) from the Social Science Genetics Association Consortium and 462 013 participants [allergic rhinitis and (or) eczema] from the UK Biobank. Genetic variants that were closely related to educational attainment were identified as instrumental variables. Two-sample MR analyses, including inverse-variance weighted (IVW), MR-Egger regression, weighted median method and weighted model-based estimation, were performed to investigate the causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema, in which the odds ratio ( OR) values were used as indicators. Results:A total of 70 single-nucleotide polymorphisms (SNPs) were chosen as instrumental variables. The MR-Egger regression results suggested that the genetic pleiotropy was unlikely to bias our results ( P=0.107). In the univariable MR analyses, IVW regression showed that the risk of allergic rhinitis and (or) eczema was OR=1.044 (95% CI: 1.020-1.069, P<0.001) and OR=1.170 (95% CI: 1.074-1.256, P<0.001), respectively, for the increase in the duration of education by one year or one standard deviation ( SD) (3.71 years). In the reverse MR analysis, IVW regression showed little evidence that allergic rhinitis and (or) eczema affected educational attainment ( OR=1.020, 95% CI: 0.927-1.023, P=0.683). The results of the weighted median method and weighted mode-based estimation were consistent with the results of IVW. Conclusion:This study suggests that there is a positive causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema, which means that educational attainment can increase the occurrence of allergic rhinitis and (or) eczema.

Objective:To determine the causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema using Mendelian randomization (MR) analyses.Methods:This study was a secondary data analysis based on the summary data of genome-wide association studies (GWAS), which involved 293 723 participants (educational attainment) from the Social Science Genetics Association Consortium and 462 013 participants [allergic rhinitis and (or) eczema] from the UK Biobank. Genetic variants that were closely related to educational attainment were identified as instrumental variables. Two-sample MR analyses, including inverse-variance weighted (IVW), MR-Egger regression, weighted median method and weighted model-based estimation, were performed to investigate the causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema, in which the odds ratio ( OR) values were used as indicators. Results:A total of 70 single-nucleotide polymorphisms (SNPs) were chosen as instrumental variables. The MR-Egger regression results suggested that the genetic pleiotropy was unlikely to bias our results ( P=0.107). In the univariable MR analyses, IVW regression showed that the risk of allergic rhinitis and (or) eczema was OR=1.044 (95% CI: 1.020-1.069, P<0.001) and OR=1.170 (95% CI: 1.074-1.256, P<0.001), respectively, for the increase in the duration of education by one year or one standard deviation ( SD) (3.71 years). In the reverse MR analysis, IVW regression showed little evidence that allergic rhinitis and (or) eczema affected educational attainment ( OR=1.020, 95% CI: 0.927-1.023, P=0.683). The results of the weighted median method and weighted mode-based estimation were consistent with the results of IVW. Conclusion:This study suggests that there is a positive causal relationship between educational attainment and the risk of allergic rhinitis and (or) eczema, which means that educational attainment can increase the occurrence of allergic rhinitis and (or) eczema.

Objective:To study the efficacy and drug-related adverse reactions of long-term appli-cation of biological anti-rheumatic drugs (bDMARDs) to patients with ankylosing spondylitis (AS), and provide reference for clinical diagnosis and treatment.Methods:We retrospectively analyzed the clinical data of AS patients who were followed-up for more than 5 years in the Department of Rheumatology and Immunology of Peking University Shenzhen Hospital. The patients treated with bDMARDs alone or combined with traditional antirheumatic drugs were included as the treatment group, while those who did not receive biological or non-biological antirheumatic therapy were included as the control group. The data collected included clinical sym-ptoms, inflammatory biomarkers, imaging results, drug applications and drug-related adverse reactions, etc. The counting data were tested by χ2 test, the measurement data in normal distribution was tested by t test, and the measurement data that not normally distributed was tested by Mann-Whitney U test. Paired test was used for statistical processing before and after treatment. Results:We collected the data of 114 eligible patients, including 64 in the treatment group and 50 in the control group. There were no significant differences in baseline data between the 2 groups, including mean follow-up time, course of disease, age, sex ratio, HLA-B27 positive rate, morning stiffness duration, night pain, peripheral arthritis, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and imaging. After 5 years, patients in the treatment group had shorter morning stiffness [(3±7) min vs (26±37) min, t=4.827, P<0.01], lower nighttime pain rates [(3/64, 4.8%) vs (29/50,58.0%), χ2=38.329, P<0.01], lower ESR level [(14±14) mm/1 h vs (20±18) mm/1 h, t=2.102, P=0.038], lower CRP level [(7±8) mg/L vs (14±19) mg/L, t=2.431, P=0.017], and lower progression rate of sacroiliac arthritis [(18/64, 28.1%) vs (35/50, 70.0%), χ2=19.786, P<0.01], than the control group. The main drug-related adverse reactions in the treatment groupincluded reversible leucopenia, elevated transaminase level, redness and swelling at the injection site. Conclusion:Biologics treatment for more than 3 consecutive years can effectively control the clinical symptoms of most AS patients, reduce inflammatory indicators and delay the imaging progression of the sacroiliac joint. Without treatment, the imaging progress of the sacroiliac joint in AS patients could be 70% after 5 years.

We report a case of chromoblastomycosis caused by , which was successfully treated by long-pulsed 1064 nm Nd: YAG laser combined with terbinafine. A 60-year-old man was admitted for the presence of a 30 mm×40 mm erythematous plaque on the dorsum of his right hand for about 10 months without any subjective symptoms. Both microscopic examination and tissue biopsy of the lesion showed characteristic sclerotic bodies of chromoblastomycosis. Lesion tissue culture on SDA at 26 ℃ for 2 weeks resulted in a black colony, and slide culture identified the isolate as Fonsecaea species. ITS sequence analysis of the isolate showed a 99% homology with strain KX078407. The susceptibility of the isolate to 9 antifungal agents was determined using the microdilution method according to the guidelines of CLSI M38-A2 protocol, and terbinafine showed the lowest MIC (0.125 μg/ml). We subsequently established a Wistar rat model of chromoblastomycosis using the clinical isolate and treated the rats with long-pulsed 1064 nm Nd: YAG laser (pulse width of 3.0 ms, fluence of 24 J/cm, spot size of 3 mm, frequency of 4 Hz, repeated 3 times at an interval of 30 s) twice a week for a total of 8 sessions. Although the laser treatment alone was not able to eliminate the fungi, histopathological examination showed the aggregation of numerous lymphocytes in the local affected tissue, indicating an immune response that consequently facilitate the regression of the lesion. The patient was successfully treated by long-pulsed 1064 nm Nd: YAG laser once a week combined with terbinafine (0.25 /bid) for 8 weeks, and follow-up for 20 months did not reveal any signs of recurrence.
Animals ; Chromoblastomycosis ; Humans ; Laser Therapy ; Lasers, Solid-State ; Male ; Middle Aged ; Rats ; Rats, Wistar ; Terbinafine ; Treatment Outcome

Objective To explore the characteristics of social behaviors in toddlers with high-risk of autism spectrum disorder (HR-ASD),and the correlation to the severity of ASD symptoms.Method 32 high-risk ASD toddlers,aged from 12 months to 24 months,and 34 typical developmental (TD) infants/toddlers,aged from 6 months to 24 months,were recruited.Behavioral video of the Still-Face Paradigm (SFP) was used to measure the frequencies and duration of social behaviors,including non-social smiling,protest,eye contact,social smiling and social positive engagement,during the mother-infant interaction and the still face.Autism Diagnostic Observation Scale was used to evaluate severity of clinical symptoms in high-risk ASD toddler.Gesell Development Scale was used to assess the developmental level of the two groups.Independent-sample t test was used to compare the differences of social behaviors between two groups.Pearson correlation analysis was used to analyze the correlation between the social behaviors of high-risk ASD and the age,the developmental level and the severity of ASD symptoms.Binary logistic regression was used to analyze the power of discrimination of social behaviors between HR-ASD and TD.Results During mother-infant interaction,compared with TD group,HR-ASD had significantly shorter duration ((19.8±23.4) s vs.(61.5±34.0) s,t=-5.75,P＜0.01;(6.5±9.3) s vs.(29.0±25.2) s,t=-4.73,P＜0.01;(3.0±8.8) s vs.(13.2±23.1) s,t=-2.34,P=0.02) and lower frequencies (t=-6.62、-3.03、-2.74,all P＜0.01) of eye contact,social smiling and social positive engagement.During the still face,compared with TD group,HR-ASD had significantly shorter duration (t=-3.32,P＜0.01;t=-2.59,P=0.01) and lower frequencies (t=-6.13、-3.48,all P＜0.01) of eye contact and social positive engagement.According to Pearson correlation analysis,during the still face,in HR-ASD group,the duration of eye contact and social positive engagement had significantly negative influence on the score of the language and communication in ADOS (r=-0.49、-0.52,all P＜0.01);The duration and frequencies of eye contact and social positive engagement had significantly negative influence on the score of mutually social interaction in ADOS (r=-0.57,P＜0.01;r=-0.49,P＜0.01;r=-0.74,P＜0.01;r=-0.44,P=0.01);The duration of eye contact and social positive engagement had significantly negative influence on the score of the playing in ADOS (r=-0.43,P=0.01;r=-0.45,P=0.01).According to binary logistic regression,the duration of social smiling during the still face and the frequencies of eye contact during mother-infant interaction could distinguish between HR-ASD and TD (OR=1.36,95％CI:1.08-1.71,P=0.01;OR=5.99,95％CI:1.15-31.14,P=0.03).Conclusion HR-ASD hasthe lower levels of eye contact,social smiling and social positive engagement,which may suggestthe severity of ASD core symptoms.The duration of social smiling during the still face and the frequencies of eye contact during mother-infant interaction may possiblyfigure out theHR-ASD and could be further developed as a predictablebehavioral maker.

Objective To explore the characteristics of social behaviors in toddlers with high-risk of autism spectrum disorder (HR-ASD),and the correlation to the severity of ASD symptoms.Method 32 high-risk ASD toddlers,aged from 12 months to 24 months,and 34 typical developmental (TD) infants/toddlers,aged from 6 months to 24 months,were recruited.Behavioral video of the Still-Face Paradigm (SFP) was used to measure the frequencies and duration of social behaviors,including non-social smiling,protest,eye contact,social smiling and social positive engagement,during the mother-infant interaction and the still face.Autism Diagnostic Observation Scale was used to evaluate severity of clinical symptoms in high-risk ASD toddler.Gesell Development Scale was used to assess the developmental level of the two groups.Independent-sample t test was used to compare the differences of social behaviors between two groups.Pearson correlation analysis was used to analyze the correlation between the social behaviors of high-risk ASD and the age,the developmental level and the severity of ASD symptoms.Binary logistic regression was used to analyze the power of discrimination of social behaviors between HR-ASD and TD.Results During mother-infant interaction,compared with TD group,HR-ASD had significantly shorter duration ((19.8±23.4) s vs.(61.5±34.0) s,t=-5.75,P＜0.01;(6.5±9.3) s vs.(29.0±25.2) s,t=-4.73,P＜0.01;(3.0±8.8) s vs.(13.2±23.1) s,t=-2.34,P=0.02) and lower frequencies (t=-6.62、-3.03、-2.74,all P＜0.01) of eye contact,social smiling and social positive engagement.During the still face,compared with TD group,HR-ASD had significantly shorter duration (t=-3.32,P＜0.01;t=-2.59,P=0.01) and lower frequencies (t=-6.13、-3.48,all P＜0.01) of eye contact and social positive engagement.According to Pearson correlation analysis,during the still face,in HR-ASD group,the duration of eye contact and social positive engagement had significantly negative influence on the score of the language and communication in ADOS (r=-0.49、-0.52,all P＜0.01);The duration and frequencies of eye contact and social positive engagement had significantly negative influence on the score of mutually social interaction in ADOS (r=-0.57,P＜0.01;r=-0.49,P＜0.01;r=-0.74,P＜0.01;r=-0.44,P=0.01);The duration of eye contact and social positive engagement had significantly negative influence on the score of the playing in ADOS (r=-0.43,P=0.01;r=-0.45,P=0.01).According to binary logistic regression,the duration of social smiling during the still face and the frequencies of eye contact during mother-infant interaction could distinguish between HR-ASD and TD (OR=1.36,95％CI:1.08-1.71,P=0.01;OR=5.99,95％CI:1.15-31.14,P=0.03).Conclusion HR-ASD hasthe lower levels of eye contact,social smiling and social positive engagement,which may suggestthe severity of ASD core symptoms.The duration of social smiling during the still face and the frequencies of eye contact during mother-infant interaction may possiblyfigure out theHR-ASD and could be further developed as a predictablebehavioral maker.

This study was aimed to analyze the "disease-syndrome-treatment-medicine" experiences of professor Ding for diabetes combined with hypertension by using "traditional Chinese medicine (TCM) inheritance support system (V2.5)".By analyzing the data,we summarized Professor Ding's academic experiences.Through collecting the standard clinical cases,combined with the software analysis system,the composing principles were analyzed by using data mining methods such as frequency statistics,revised mutual information,association rules analysis,cluster analysis,improvement of mutual information,complex system entropy clustering,unsupervised hierarchical clustering entropy and so on.The analysis results showed that 28 patients with diabetes combined with hypertension of yin-deficiency and yang-hyperactivity syndrome,the characteristics were discovered that the highest-frequency used drugs of Ping Gan Xi Feng were concha haliotidis,concha margaritifera,rhizoma gastrodiae;the highest-frequency used drug combinations were "radices rehmanniae,rhizoma dioscoreae","folium mori,cortex mori","semen cuscutae,rhizoma dioscoreae,radices rehmanniae" and so on.Analyzing the 27 patients with diabetes combined with hypertension "wind and fire evils stir up syndrome,the characteristics were discovered that the highest-frequency used drugs of Ping Gan Xi Feng were concha haliotidis,concha margaritifera.In addition to the most common combinations used in diabetes,there were "rhizoma coptidis,spica prunellae","spica prunellae,folium mori","rhizoma coptidis,radices rehmanniae,cortex lycii","spica prunellae,folium mori,rhizoma coptidis" and so on.It was concluded that the syndrome differentiation and treatment of diabetes combined with hypertension was focused on the etiology and pathogenesis of wind and fire.The main treatment principle was to calm the liver to stop the wind,nourish yin and suppress hyperactive yang.

Objective:To compare the efficacy and safety of octreotide and somatostatin in the treatment of liver cirrhosis and up-per digestive tract hemorrhage. Methods:The randomized controlled trails ( RCTs) on the comparison between octreotide and soma-tostatin in the treatment of liver cirrhosis and upper digestive tract hemorrhage were searched from Cochrane Library, PubMed, Med-line, Embase, China National Knowledge Infrastructure(CNKI), VIP China Science and Technology Journal Database and Wanfang database (till February 2017). The randomized controlled trails meeting the inclusion criteria were collected and the quality of included RCTs was assessed according to the Cochrane Collaboration system review, and then Meta -analysis was performed using RevMan 5. 3 software after data extraction and bias risk assessment. Results:A total of 11 RCTs were included. Meta-analysis showed the efficacy of octreotide group was similar to that of somatostatin group (OR=1. 10, 95%CI:0. 79-1. 53, P=0. 56). The levels of blood transfu-sion and hemostasis of octreotide group were higher than those of somatostatin group (MD=0. 68, 95%CI:0. 54-0. 82, P<0. 01 and MD=6. 26, 95%CI:4. 89-7. 63, P<0. 01). The risk of abdominal pain in octreotide group was lower than that in somatostatin group (OR=0. 43, 95%CI:0. 22-0. 86, P=0. 02). The other adverse reactions were similar in both groups. Conclusion:The efficacy of octreotide is similar to that of somatostatin in the treatment of liver cirrhosis and upper digestive tract hemorrhage, and the effect of som-atostatin is quicker than that of octreotide with less blood transfusion. The adverse reactions are similar in both groups, except that oct-reotide has a lower risk of abdominal pain. The long-term safety of octreotide still needs to be confirmed by performing higher quality and large-sample RCTs.

Objective To summarize the experience in nursing patients undergoing skin biopsy on head and face . Method One hundred and twenty patients with head facial dermatosis undergoing skin tissue biopsy were nursed from August 2012 to October 2013. Result All operation for biopsy were completed smoothly, with the cure rate at the first phase 100.0%, healing time 5~7 days, averaged (7.0 ± 3.0)d and no complications. Conclusion For those patients having undergone facial skin tissue biopsy, the nursing measures like psychological nursing, health education before operation, preoperative relief of mental disorder, postoperative wound nursing and health education, prevention of complications are critical for their recovery.