Objective:To analyze serum inflammatory factors associated with antihistamine resistance in patients with chronic spontaneous urticaria (CSU) .Methods:A total of 88 CSU patients were enrolled from Guangzhou Dermatology Hospital from January 2022 to December 2024. All patients received antihistamine treatment according to the "Guideline for diagnosis and treatment of urticaria in China (2022) " . Based on the 7-day urticaria activity score (UAS7) after 4-week treatment, these patients were divided into an antihistamine-sensitive group and an antihistamine-resistant group. Serum levels of inflammatory factors at the initial visit were analyzed using the Olink-targeted proteomics technology. Specific biomarkers associated with antihistamine resistance were identified, and Spearman correlation analysis was carried out to analyze correlations among differentially expressed proteins. A logistic regression model was constructed based on the Olink proteomics data, and the predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve analysis. Measurement data were expressed as mean ± standard deviation or median (lower quartile, upper quartile) .Results:The 88 CSU patients aged 12 to 81 (38.78 ± 13.89) years, with the disease duration being 18 (7.00, 60.00) months. There were 32 patients in the antihistamine-sensitive group and 56 in the antihistamine-resistant group. No significant differences were found between the two groups in terms of age, disease duration, gender, or history of allergic diseases (all P > 0.05) . After 4 weeks of antihistamine treatment, the UAS7 score was significantly higher in the antihistamine-resistant group (25.00 [15.25, 31.00] points) than in the antihistamine-sensitive group (0.50 [0.00, 4.00] points; Z = -7.08, P < 0.001) . The Olink-targeted proteomics identified 5 differentially expressed proteins between the two groups: compared with the antihistamine-sensitive group, the antihistamine-resistant group showed > 2-fold higher expression of fibroblast growth factor 19 (FGF19) , interleukin-15 receptor subunit alpha (IL-15RA) , eotaxin (CCL11) , and monocyte chemoattractant protein-1 (MCP-1) ; in contrast, the expression of sulfotransferase 1A1 (ST1A1) in the antihistamine-sensitive group was 2.54 times that in the antihistamine-resistant group. Among the differentially expressed proteins, MCP-1 showed the highest specificity (1.00) for predicting antihistamine resistance, followed by CCL11 (0.97) . Correlation analysis revealed a significant positive correlation between MCP-1 and CCL11, and a significant negative correlation between IL-15RA and ST1A1. ROC curve analysis showed that MCP-1 and CCL11 had area under the curve values of 0.603 and 0.630, respectively, in predicting antihistamine resistance. Conclusion:MCP-1 and CCL11 may be potential biomarkers for predicting antihistamine resistance in CSU patients.

Objective:To analyze serum inflammatory factors associated with antihistamine resistance in patients with chronic spontaneous urticaria (CSU) .Methods:A total of 88 CSU patients were enrolled from Guangzhou Dermatology Hospital from January 2022 to December 2024. All patients received antihistamine treatment according to the "Guideline for diagnosis and treatment of urticaria in China (2022) " . Based on the 7-day urticaria activity score (UAS7) after 4-week treatment, these patients were divided into an antihistamine-sensitive group and an antihistamine-resistant group. Serum levels of inflammatory factors at the initial visit were analyzed using the Olink-targeted proteomics technology. Specific biomarkers associated with antihistamine resistance were identified, and Spearman correlation analysis was carried out to analyze correlations among differentially expressed proteins. A logistic regression model was constructed based on the Olink proteomics data, and the predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve analysis. Measurement data were expressed as mean ± standard deviation or median (lower quartile, upper quartile) .Results:The 88 CSU patients aged 12 to 81 (38.78 ± 13.89) years, with the disease duration being 18 (7.00, 60.00) months. There were 32 patients in the antihistamine-sensitive group and 56 in the antihistamine-resistant group. No significant differences were found between the two groups in terms of age, disease duration, gender, or history of allergic diseases (all P > 0.05) . After 4 weeks of antihistamine treatment, the UAS7 score was significantly higher in the antihistamine-resistant group (25.00 [15.25, 31.00] points) than in the antihistamine-sensitive group (0.50 [0.00, 4.00] points; Z = -7.08, P < 0.001) . The Olink-targeted proteomics identified 5 differentially expressed proteins between the two groups: compared with the antihistamine-sensitive group, the antihistamine-resistant group showed > 2-fold higher expression of fibroblast growth factor 19 (FGF19) , interleukin-15 receptor subunit alpha (IL-15RA) , eotaxin (CCL11) , and monocyte chemoattractant protein-1 (MCP-1) ; in contrast, the expression of sulfotransferase 1A1 (ST1A1) in the antihistamine-sensitive group was 2.54 times that in the antihistamine-resistant group. Among the differentially expressed proteins, MCP-1 showed the highest specificity (1.00) for predicting antihistamine resistance, followed by CCL11 (0.97) . Correlation analysis revealed a significant positive correlation between MCP-1 and CCL11, and a significant negative correlation between IL-15RA and ST1A1. ROC curve analysis showed that MCP-1 and CCL11 had area under the curve values of 0.603 and 0.630, respectively, in predicting antihistamine resistance. Conclusion:MCP-1 and CCL11 may be potential biomarkers for predicting antihistamine resistance in CSU patients.

Objective:To investigate the predictive value of F-2-fluoro-2-deoxy-D-glucose ( 18F-FDG) PET-CT metabolic parameters for the recurrence of type 1 autoimmune pancreatitis (AIP). Methods:Eighty-six patients with type 1 AIP who met the International Consensus Diagnostic Criteria (ICDC) and underwent 18F-FDG PET-CT before interventional treatment at the PLA General Hospital between May 2009 and June 2021 were included and divided into recurrence group ( n=43) and no-recurrence group ( n=43) according to whether they recurred after treatment. The standard uptake value (SUV)≥2.5 fixed threshold was used to outline the pancreatic lesion volume of interest (VOI) in three dimensions, and the three-dimensional diameter of the lesion, maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), peak standardized uptake value (SUVpeak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), target-to-bench ratio (TBR) and standardized uptake value ratio (SUVR) were measured to compare the clinical characteristics, biochemical indices and treatment of the two groups; univariate and multifactorial regression analysis were used to examine 18F-FDG PET/CT visual indices of pancreatic lesions and extra-pancreatic involved organs as well as metabolic parameters in the two groups. A recurrence prediction model was constructed and its predictive efficacy was assessed. Results:The proportion of patients receiving glucocorticoid maintenance therapy was significantly higher in the no-recurrence group than in the recurrence group (58% vs 23.3%), and the serum IgG4 levels before treatment were significantly higher in the recurrence group [(15 309±11 724) mg/L vs (8 816±7 169) mg/L]. The results of univariate analysis showed that the proportion of extra-pancreatic salivary gland involvement and VOI, SUVmax, SUVpeak, SUVR, TBR, MTV, and TLG were significantly higher in the recurrence group than in the no-recurrence group, and the differences were statistically significant (all P values <0.05); the results of multivariate analysis showed that VOI ( OR=1.012, 95% CI 1.001-1.023 ), SUV max ( OR=1.398, 95% CI 1.029-1.899), SUV peak ( OR=1.408, 95% CI1.002-1.978), SUVR ( OR=1.977, 95% CI1.036-3.771) and MTV ( OR=1.012, 95% CI1.000- 1.022) in the recurrence group were significantly higher than those in the no-recurrence group, and all differences were statistically significant (all P values <0.05). The prediction model was constructed by multifactorial binary logistic regression analysis of SUVR>2, MTV>36 cm 3, and IgG4>11 400 mg/L, which had an AUC of 0.800 (95% CI 0.704-0.897), sensitivity of 81.4% (95% CI 0.661-0.911), specificity of 74.4% (95% CI 0.585-0.860), and prediction accuracy of 77.9%. Conclusions:18F-FDG PET/CT metabolic parameters can be used as predictors of type 1 AIP recurrence; a multiparameter model constructed based on metabolic parameters SUVR, MTV and IgG4 has a good predictive efficacy for predicting type 1 AIP recurrence.

Objective To analyze the differences of von Mises stress distribution in knee cartilage and meniscus in female with generalised joint hypermobility (GJH) and healthy female during drop jump landing. Methods The kinematic and ground reaction force (GRF) characteristics of knee joint in female with GJH and healthy female at the moment of peak vertical GRF (VGRF) during loading phase of drop jump landing were collected. The knee joint reaction force was calculated via inverse dynamics, and the combined force of knee joint along long axis of the femur was applied as the load. Based on three-dimensional (3D) finite element model of a female knee joint, numerical simulations were performed separately during drop jump landing of subjects in two groups, and von Mises stresses and stress distribution of knee cartilage and meniscus were calculated. Results At the moment of peak VGRF during drop jump landing, knee flexion and valgus angles in GJH group and control group showed a statistical significance (P<0. 05). Compared with control group, knee flexion angle decreased and valgus angle increased in GJH group. During drop jump landing, GJH group bore larger stress inside the knee joint, and stress distribution in weight-bearing areas of the medial and lateral tibiofemoral compartments was uneven, while the lateral femoral cartilage lateral condyle, the anterior and middle lateral of lateral tibial cartilage, the anterior angle and body lateral margin of lateral meniscus were stress concentration sites. Conclusions For females with GJH, the stability of knee joint decreases and force lines change in jumping events, due to the increased range of motion of knee joint and relaxation of joint capsule, which increases the risk of cartilage and meniscal injury in lateral knee joint. During jumping sports, females with GJH should especially prevent knee joint injury caused by altered force lines in frontal plane of knee joint.

Objective:To evaluate the efficacy and safety of endoscopic biliary drainage for biliary fistula.Methods:Data of consecutive 409 biliary fistula patients who were treated and diagnosed at the First Medical Center of Chinese PLA General Hospital from November 2002 to November 2022 were reviewed, and 53 patients who received endoscopic retrograde cholangiopancreatography (ERCP) drainage were finally included. General information, procedural conditions, clinical outcomes and adverse events were analyzed. The patients were categorized into two groups: the endoscopic retrograde biliary drainage (ERBD) group ( n=46) and the endoscopic nasobiliary drainage (ENBD) group ( n=7). Procedural characteristics, operation outcomes, and operation time were compared between the two groups. Results:There were 36 males and 17 females, with the age of 52.2±12.7 years, among whom 58.5% (31/53) were secondary to cholecystectomy. Clinical success was achieved in 83.0% (44/53) patients, with the operation time of 27.0 (13.5, 33.5) minutes and the treatment session of 1 (1, 2). The time to resolution was 89 (47, 161) days. The success rate of ERCP for low-grade biliary fistula was higher compared with that of high-grade biliary fistula [96.4% (27/28) VS 68.0% (17/25), χ2=7.57, P=0.006]. Bridging drainage achieved higher success rate compared with that of non-bridging drainage [91.7% (33/36) VS 64.7% (11/17), χ2=5.95, P=0.015], while different diameters of stents (≥10 Fr VS <10 Fr) achieved similar success rate [81.8% (27/33) VS 84.6% (11/13), χ2=0.05, P=0.822]. Adverse events occurred in 10 patients (18.9%), including 6 pancreatitis, 2 bleeding, 1 cholangitis and 1 death. Except for 1 death, 9 other adverse events were mild and managed with conservative treatment without interventions. There was no significant difference in clinical success rate [6/7 VS 82.6% (38/46), χ2=0.04, P=0.838] or the median operation time [28.0 min VS 23.0 min, Z=0.38, P=0.774] between ENBD group and ERBD group. Conclusion:Endoscopic biliary drainage is safe and effective for biliary fistula. ENBD and ERBD have comparable clinical efficacy. ERCP for low-grade biliary fistula may achieve a higher success rate, and bridging drainage may facilitate fistula resolution.

Objective: To analyze Internet behaviors of children and adolescents and their influencing factors, and to provide scientific basis for health education guidance and prevention measures. Methods: A stratified cluster sampling method was used. From January to June 2019, 30 955 primary school students in 16 provinces (municipalities), from eastern, central, and western economic zones of China were selected to conduct a questionnaire survey, regarding general demographics, diet and exercise, tobacco, alcohol and sleep, Internet and electronics usage, etc. Results: Among them, 43.1% of students had never been online with girls (44.7%) higher than boys (41.8%)(χ2=21.04, P<0.01); 1.3% of students reported online time for more than 4 hours a day, boys were significantly higher than girls(χ2=15.87, P<0.01); Internet addiction was detected in 2.4% of elementary school students, with boys (3.0%) higher than girls(1.7%)(χ2=331.77, P<0.01), and the trend increases with grade. With sixth grade (3.3%) were significantly higher than children from the first grade (0.8%) and other grades(χ2=163.96, P<0.01). Children’s tendency to Internet addiction was 11.9%, of which boys were 13.0% and girls were 10.6%, boys were significantly higher than girls(χ2=117.66, P<0.01). Pearson correlation analysis revealed that, after controlling gender age, boarding school, family relationship, single parents and regrouped families, smoking, drinking sugary drinks, eating fried foods, and left-behind were positively related to Intenet addiction(r=0.06, 0.07, 0.27, 0.44, 0.07, 0.11, 0.09, P<0.01), while medium and high intensity sports, effective physical education, health education in school, AIDS education and parental restrictions on TV and computer games, were negatively associated with internet addiction(r=-0.74, -0.65, -0.04, -0.05, -0.63, P<0.01). Conclusion The internet addiction of Chinese primary school students is common and increases by year. High-intensity, high-density sports, effective physical education, and health education could help prevent Internet addiction among children.

Objective To investigate the relationship between the trauma severity and the usage of antibacterial drugs and to provide reference for standard protocol of proper antibiotic use in wound care.Methods ICD-10 and AIS were used to set up the relationship and to analyze the use of antibiotics in patients with different trauma score.Results 25 035 trauma patients were enrolled in this study.Those patients were divided into five groups according to the AIS score with least severe as group 1 to most severe as group 5.The patient percentage in group 1 to 5 was 21.92％,67.73％,8.86％,0.97％ and 0.52％ respectively.The five most frequently used antibiotic classes are second generation cephalosporins,third generation cephalosporins,first generation cephalosporins,fluoroquinolones and penicillin/beta lactamase inhibitor combination, accounted for 29.69％,22.57％,20.33％,4.66％ and 4.47％ of total DDDs of antibacterial drugs.Individually, the top 10 antibiotics are cefuroxime (12.21％), cefazolin (8.31％), ceftriaxone (7.74％), cefathiamidine (7.34％), cefotiam (4.87％), ceftazidime (3.68％), amoxicillin/clavulanic acid (3.63％), levofloxacin (3.59％), cefoxitin (3.56％), flucloxacillin (3.52％);gentamicin (2.27％), ornidazole (2.00％) and cefoperazone/tazobactam (1.44％) were used most in their categories respectively.The variety and quantity of antibacterial drugs used for different trauma patients were different.Conclusion The trauma score based on ICD-AIS can reflect the severity of trauma.The use of antibiotics in patients with different trauma score can provide reference for the clinical applications of antibiotics in wound care.

Objective To compare the co-prescribing patterns of antibacterials between clinic and ER in a tertiary hospi-tal and mine the association rules among drugs in outpatient and emergency prescriptions .Methods The prescribing data of 2009 were sampled and the prescription drugs were classified according to the anatomical therapeutic chemical (ATC) subgroup code .IBM PASW ○R Modeler 14 was used for data processing and statistics ,and the Apriori association analysis model was es-tablished to carry out data mining .Results There were differences between outpatient and emergency prescriptions with anti-microbial in average number of drug items and antibacterials items ,as well as in the distribution of patient age and gender .Ex-pectorants ,cough suppressants and prepared Chinese medicine for “Qing Re Jie Du” played dominant roles in the associations with cephalosporin in outpatient prescription .More association rules in emergency prescriptions were found which were more complicated .The associations between antibacterials and vitamins ,digestive ulcer drugs ,and potassium agents ,as well as an-tibacterial and antibacterials were not found in the outpatient prescriptions .Conclusion The use of antibacterials in the emer-gency is much more frequently than in the clinic ,especially for the inject-able formulations and the combination of antibacteri-als .So it is more necessary to establish a standard for rational use of antibacterials in ER .

Objective To detect the expression of caveolin-1 and PY14caveolin-1 in different esophageal tissues,and study the relationships between the expressions of caveolin-1 and PY14caveolin-1 with the occurrence and development of esophageal squamous cell carcinoma.Methods The fresh surgical specimens in 60 patients with esophageal squamous cell carcinoma were collected and Western blotting were used to analyze and detect the expressions of caveolin-1 and PY14caveolin-1 in esophageal squamous cell carcinoma,adjacent esophageal tissues and normal esophageal tissues.The expression of cav-1 and PY14caveolin-1 with esophageal squamous cell carcinoma were analyzed.Results The expressions of caveolin-1 and PY14caveolin-1 in esophageal squamous cell carcinoma were much higher than that in adjacent tissues and normal esophageal tissues,and the difference between them was statistically significant(P＜0.05).Conclusion The expression of caveolin-1 and PY14caveolin-1 in esophageal squamous cell carcinoma, adjacent esophageal tissues and normal esophageal tissues decreases successively,it suggests the caveolin-1 and PY14caveolin-1 may be the key of the occurrence and development of esophageal cancer cells and they could be involved in the migration and invasion of esophageal cancer.

To compare the concepts of pharmaceutical care and health management , analyze their internal connections both in present background and implementation process .Further development and practice of pharmaceutical care under the new health manage -ment model were discussed .