1.Interpretation of Middle-regulating Formulas Based on Fuxing Jue
Junqiao AN ; Yixin MA ; Dongmei LI ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):265-272
The Dunhuang manuscript Fuxing Jue takes the "Tangye Jingfa Tu" as the core of its theory on prescription and compatibility. Its medication principles mainly include the "five elements principle of tonifying and purging" and the "five elements principle of elimination and transformation". Based on the differentiation of deficiency and excess in the five Zang organs, it flexibly applies medicinal properties, usage, and flavor transformation for tonifying and purging, forming its unique method of medication and compatibility. In Taiyin disease, "fullness syndrome" often occurs together with "diarrhea", and these two conditions also serve as the primary indications for the middle-regulating formulas. Among them, Lizhong Wan (Tang) mainly address Taiyin deficiency. The three Xiexin Tang (Banxia Xiexin Tang, Gancao Xiexin Tang, Shengjiang Xiexin Tang) address Taiyin deficiency accompanied by pathogenic excess. The Sini Tangand Tongmai Sini Tang primarily treat dysfunction of the liver, spleen, and kidney with impaired opening and closing of Taiyin, manifesting as diarrhea. The medicinal flavors of middle-regulating formulas are pungent, sweet, and bitter, acting directly on the spleen of Taiyin. The pungent flavor induces purging of the spleen, sweet flavor tonifies the spleen, and bitter flavor eliminates lumps. When the constituent medicinal units of middle-regulating formulas are unified, the ratio of pungent to sweet flavors reflects the tonic and purgative strength of the formula. In addition, the two decoction methods, "short-term decoction to extract Qi" and "long-term decoction to extract flavor", also influence the formula's tonifying and purgative effects. Based on the composition of flavors and special decoction methods, this article discusses the differences in the use of middle-regulating formulas for treating "“fullness syndrome" versus "diarrhea". Dysfunction of the spleen can give rise to various diseases. Therefore, middle-regulating formulas are not limited to treating "deficiency, cold, and dampness" syndromes. Later generations of physicians further modified Lizhong Tang to treat "excess, heat, and dryness" syndromes, laying a solid foundation for more flexible and effective clinical application of middle-regulating formulas.
2.Interpretation of Middle-regulating Formulas Based on Fuxing Jue
Junqiao AN ; Yixin MA ; Dongmei LI ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):265-272
The Dunhuang manuscript Fuxing Jue takes the "Tangye Jingfa Tu" as the core of its theory on prescription and compatibility. Its medication principles mainly include the "five elements principle of tonifying and purging" and the "five elements principle of elimination and transformation". Based on the differentiation of deficiency and excess in the five Zang organs, it flexibly applies medicinal properties, usage, and flavor transformation for tonifying and purging, forming its unique method of medication and compatibility. In Taiyin disease, "fullness syndrome" often occurs together with "diarrhea", and these two conditions also serve as the primary indications for the middle-regulating formulas. Among them, Lizhong Wan (Tang) mainly address Taiyin deficiency. The three Xiexin Tang (Banxia Xiexin Tang, Gancao Xiexin Tang, Shengjiang Xiexin Tang) address Taiyin deficiency accompanied by pathogenic excess. The Sini Tangand Tongmai Sini Tang primarily treat dysfunction of the liver, spleen, and kidney with impaired opening and closing of Taiyin, manifesting as diarrhea. The medicinal flavors of middle-regulating formulas are pungent, sweet, and bitter, acting directly on the spleen of Taiyin. The pungent flavor induces purging of the spleen, sweet flavor tonifies the spleen, and bitter flavor eliminates lumps. When the constituent medicinal units of middle-regulating formulas are unified, the ratio of pungent to sweet flavors reflects the tonic and purgative strength of the formula. In addition, the two decoction methods, "short-term decoction to extract Qi" and "long-term decoction to extract flavor", also influence the formula's tonifying and purgative effects. Based on the composition of flavors and special decoction methods, this article discusses the differences in the use of middle-regulating formulas for treating "“fullness syndrome" versus "diarrhea". Dysfunction of the spleen can give rise to various diseases. Therefore, middle-regulating formulas are not limited to treating "deficiency, cold, and dampness" syndromes. Later generations of physicians further modified Lizhong Tang to treat "excess, heat, and dryness" syndromes, laying a solid foundation for more flexible and effective clinical application of middle-regulating formulas.
3.Analysis of sensitization characteristics and changing trends of common allergens in a children′s hospital in Shanghai City from 2020 to 2024
Hanhua LI ; Yazhou WU ; Yixin JIN ; Shaohua HU ; Zhan MA ; Wenhao WENG
Chinese Journal of Preventive Medicine 2025;59(6):844-856
Objective:To explore the clinical distribution characteristics and changes of common inhalant allergens and food allergens in all outpatient and inpatient children visiting Shanghai Children′s Hospital from 2020 to 2024, and to provide a basis for the diagnosis, treatment and prevention of allergic diseases in children.Methods:A retrospective cohort study was conducted to retrospectively enroll all outpatient and inpatient children who visited Shanghai Children′s Hospital and underwent serum allergen-specific IgE (sIgE) antibody testing from January 2020 to August 2024, and the characteristics and changing trends of allergens in the past 5 years were analyzed. A total of 127 310 tests were included. There were 76 776 male tests (60.31%) and 50 534 female tests (39.69%). There were 27 392 tests (21.52%) aged 0-3 years (infant group), 51 596 tests (40.53%) aged 4-6 years (preschool group), 44 574 tests (35.01%) aged 7-12 years (school-age group), and 3 748 tests (2.94%) aged 13-18 years (adolescent group). The χ2 test was used for statistical analysis. Results:The difference in total positivity rate between different years was statistically significant ( χ2=2 907.478, P<0.001). The positive rates of inhalant allergens such as house dust, Dermatophagoides pteronyssinus/ Dermatophagoides farinae, cockroach, cat dander, mugwort, Humulus scandens, mold fungi mix, and food allergens such as beef and mutton increased significantly with age (The χ2 values were 649.496, 3 414.686, 303.247, 1 277.408, 40.477, 189.952, 600.737, 203.198, and 15.301, respectively, and the P values were <0.001, <0.001, <0.001, <0.001, <0.001, <0.001,<0.001,<0.001, and 0.002, respectively). The positive rates of inhalant allergen such as Ambrosia elatior (1.59%) and food allergens such as egg white (17.36%), milk (30.48%), shrimp (8.27%), crab (8.13%), codfish (2.61%), salmon (0.66%), mytilus edulis (2.89%), lobster/scallop (5.27%), cashew nuts (5.09%), peanuts (3.54%), and soybean (1.73%) were highest at the age of 0-3 years and decreased significantly with age (The χ2 values were 10.365, 2 407.443, 139.085, 872.548, 870.245, 106.823, 47.674, 47.244, 559.422, 369.800, 384.788, 153.660, respectively, and the P values were 0.016, 0.000,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001, respectively). Inhaled allergens mainly have a greater impact on children with respiratory-related diseases such as allergic rhinitis and asthma, while food allergens mainly have a greater impact on children with atopic dermatitis/eczema. The positive rate of sIgE of various allergens in the allergic rhinitis combined asthma group were higher than that of allergic rhinitis alone, and the sIgE positive rate of total allergens and inhaled allergens was significantly higher than that of allergic rhinitis alone ( χ2=20.851, 39.155, the P values were both<0.001). Among them, the sIgE positive rate of Ambrosia elatior and cashew nuts showed significant difference ( χ2=5.044, 8.420, P=0.025, 0.004); and the sIgE positive rate of Dermatophagoides pteronyssinus/ Dermatophagoides farinae, cat dander, grass pollens mix and mold fungi mix had extremely significant difference ( χ2=26.409, 25.990, 21.283, 16.411, the P values were all <0.001). The inhaled allergens and food allergens with the highest positive rates in the 5 years were Dermatophagoides pteronyssinus/ Dermatophagoides farinae (56.21%) and milk (47.47%), and as time went by, the positive rates gradually decreased. There is a moderate correlation between the three allergens of Ambrosia elatior, Amaranthus retroflexus, and tree pollens mix (0.55, 0.70, 0.63), and there is a moderate correlation between mango and tree pollens mix (0.50). Conclusion:Dermatophagoides pteronyssinus/ Dermatophagoides farinae, cat dander, dog dander, egg white, and milk may be important allergens for children in Shanghai City from 2020 to 2024. The positive rates vary among different genders, age groups, and disease groups, but the positive rates of Dermatophagoides pteronyssinus/ Dermatophagoides farinae, milk and cat dander allergens remain in the top three.
4.Tougu Xiaotong Capsules for treating arthritis according to the principle of"Same Treatment for Different Diseases":analysis based on integrated pharmacology,molecular docking techniques and molecular dynamics simulation
Yixin LIN ; Wenyi WANG ; Xiaoqing LEI ; Dezun MA ; Yanfeng HUANG ; Changlong FU ; Jinxia YE
Chinese Journal of Tissue Engineering Research 2025;29(24):5093-5101
BACKGROUND:Our previous research found that Tougu Xiaotong Capsules can be used not only for the treatment of osteoarthritis,but also for rheumatoid arthritis and gouty arthritis.However,the specific mechanism of action of"Same Treatment for Different Diseases"is still unclear.OBJECTIVE:To identify the main effects and mechanisms of Tougu Xiaotong Capsules in the treatment of osteoarthritis,rheumatoid arthritis and gouty arthritis with the treating principle of"Same Treatment for Different Diseases"by the methodologies of integrated pharmacology,molecular docking techniques and molecular dynamics simulation.METHODS:The active chemical components of Tougu Xiaotong Capsules and their corresponding targets were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and the Swiss Target Prediction database.The disease genes for osteoarthritis,rheumatoid arthritis and gouty arthritis were obtained from the GeneCards and OMIM databases.Cytoscape 3.7.2 software was used to construct a drug-component-disease-target network diagram and a protein-protein interaction network.Gene ontology analysis and Kyoto Encyclopedia of Genes and Genomes enrichment analysis were conducted using the Daivd database.Molecular docking simulations were performed on the CB-DOCK2 website,and molecular dynamics simulations were carried out using the GROMACS 2020.6 software.RESULTS AND CONCLUSION:(1)A total of 50 active components of Tougu Xiaotong Capsules were screened,with 184 potential targets and 29 intersection targets across the three types of arthritis.(2)The gene ontology enrichment analysis of the intersection targets indicated that the key gene functions of Tougu Xiaotong Capsules in treating the three types of arthritis were found to be cellular response to lipopolysaccharide,inflammatory response,extracellular matrix,protein binding,and zinc ion binding.(3)Kyoto Encyclopedia of Genes and Genomes enrichment analysis identified key pathways as interleukin-17 signaling pathway,tumor necrosis factor signaling pathway,NOD-like receptor and Toll-like receptor signaling pathways.(4)Six core targets[interleukin-6,interleukin-1β,prostaglandin endoperoxide synthase 1,prostaglandin endoperoxide synthase 2,cytochrome P450 1A2(CYP1A2)and C-X-C chemokine ligand 8]were determined based on the protein-protein interaction network.(5)Molecular docking results confirmed that(+)-catechin,β-sitosterol,kaempferol,myricetin,and wallichilide had good structure-activity relationships.Molecular dynamics simulations further confirmed the stable binding of CYP1A2 with wallichilide,corroborating the network pharmacology and molecular docking results.Therefore,Tougu Xiaotong Capsules may regulate the interleukin-17 signaling pathway,tumor necrosis factor signaling pathway,and other signaling pathways by targeting interleukin-1β,prostaglandin endoperoxide synthase 1,prostaglandin endoperoxide synthase 2 and CYP1A2,exert an effect of"Same Treatment for Different Diseases"on osteoarthritis,rheumatoid arthritis and gouty arthritis.
5.Effects and mechanisms of capsaicin on full-thickness skin defects in diabetic mice
Hao MA ; Peiru MIN ; Yixin ZHANG ; Liuhanghang CHENG
Chinese Journal of Burns 2025;41(7):645-654
Objective:To investigate the effects and mechanisms of capsaicin on full-thickness skin defects in diabetic mice.Methods:This study was an experimental study. Thirty-six male db/db mice aged 6-8 weeks were taken. Circular full-thickness skin defect wounds (6 mm in diameter) were created on their backs. According to the random number table method (grouping method same below), the mice were divided into control group, low-concentration capsaicin group, and high-concentration capsaicin group injected with normal saline, 10 μmol/L capsaicin solution, and 20 μmol/L capsaicin solution, respectively ( n=12). Immediately after modeling and on day 2, 30 μL of the corresponding solution was injected locally into the wounds. At 4, 8, and 12 days after injury, wound healing status was observed grossly and the percentage of residual wound area was calculated. At 12 days after injury, the proportions of inflammatory cell, collagen fiber, and CD31-positive expression areas in the wound of mice were observed and detected respectively using hematoxylin and eosin staining, Masson staining, and immunohistochemical staining, and the protein expression of transient receptor potential vanilloid type 1 (TRPV1) in the wound tissue of mice was detected using Western blotting. Human primary fibroblasts were prepared from normal skin tissue obtained from 5 patients (2 male and 3 female patients, aged 20-45 years) who were admitted to the Department of Plastic and Reconstructive Surgery of Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine in October 2024. Cells in the logarithmic growth phase (passages 2-5) were used for subsequent experiments. Cells were divided into control group and high-concentration capsaicin group, cultured in complete media without or with 20 μmol/L capsaicin, respectively. After 24 hours of culture, differentially expressed genes (DEGs) between two groups were identified using the DESeq2 R package, followed by gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis. The cells were divided into control group, low-concentration capsaicin group, and high-concentration capsaicin group, which were cultured in complete media without capsaicin, and with 10 μmol/L capsaicin, and with 20 μmol/L capsaicin, respectively. After 48 hours of culture, cell apoptosis status was assessed using flow cytometer. The protein expression levels of protein kinase B (Akt), phosphorylated Akt (p-Akt), mammalian target of rapamycin (mTOR), and phosphorylated mTOR (p-mTOR) in cells were detected by Western blotting, and the p-Akt/Akt and p-mTOR/mTOR ratios were calculated. At 12 days after injury, the protein expression levels of Akt, p-Akt, mTOR, and p-mTOR in the wounds of diabetic mice in both control group and high-concentration capsaicin group were detected by Western blotting, and the p-Akt/Akt and p-mTOR/mTOR ratios were calculated. All animal experiments used a sample size of 6, and all cellular experiments used 3. Results:At 4 days after injury, the wounds of three groups of diabetic mice began to heal gradually, and the percentages of residual wound area of mice in both low-concentration capsaicin group and high-concentration capsaicin group were significantly lower than that in control group (with t values of 2.31 and 2.87, respectively, P<0.05). At 8 days after injury, the percentages of residual wound area of mice in both low-concentration capsaicin group and high-concentration capsaicin group were significantly lower than that in control group (with t values of 2.55 and 5.38, respectively, P<0.05). At 12 days after injury, the percentages of residual wound area of mice in both low-concentration capsaicin group and high-concentration capsaicin group remained significantly lower than that in control group (with t values of 3.31 and 6.24, respectively, P<0.05), with the high-concentration capsaicin group showing a significantly greater reduction compared to that in low-concentration capsaicin group ( t=3.42, P<0.05). At 12 days after injury, the proportion of inflammatory cell area in the wound of mice in high-concentration capsaicin group was (6.2±1.8)%, significantly lower than (15.5±3.0)% in control group ( t=6.45, P<0.05). The proportion of collagen fiber area, proportion of CD31-positive expression area, and protein expression of TRPV1 in the wound of mice in high-concentration capsaicin group were significantly higher compared with those in control group (with t values of 5.48, 7.11, and 15.41, respectively, P<0.05). After 24 hours of culture, 51 DEGs with significantly differential expression were detected in high-concentration capsaicin group of cells compared with those in control group ( P<0.05), with 31 upregulated and 20 downregulated genes. GO analysis showed that the significantly upregulated and significantly downregulated DEGs mainly participated in biological processes such as extracellular matrix (ECM) polymerization, extracellular structure organization, collagen metabolic process regulation, and ECM component secretion regulation. KEGG analysis showed that the significantly upregulated and significantly downregulated DEGs mainly participated in cell apoptosis-related pathways such as the phosphatidylinositol 3-kinase/Akt pathway and tumor necrosis factor signaling pathway. After 48 hours of culture, the cell apoptosis rates in both low-concentration capsaicin group and high-concentration capsaicin group were significantly lower than that in control group (with t values of 6.38 and 9.09, respectively, P<0.05). The p-mTOR/mTOR ratio in cells in low-concentration capsaicin group was significantly higher than that in control group ( t=2.74, P<0.05). The p-Akt/Akt and p-mTOR/mTOR ratios in cells in high-concentration capsaicin group were significantly higher than those in control group (with t values of 4.43 and 3.33, respectively, P<0.05). At 12 days after injury, the p-Akt/Akt and p-mTOR/mTOR ratios in wounds of diabetic mice in high-concentration capsaicin group were 0.470±0.044 and 0.549±0.106, respectively, which were significantly higher than 0.189±0.058 and 0.241±0.120 in control group (with t values of 6.67 and 3.36, respectively, P<0.05). Conclusions:Capsaicin can promote the healing of full-thickness skin defect wounds in diabetic mice by activating the Akt/mTOR signaling pathway in fibroblasts, thereby inhibiting apoptosis.
6.Time series analysis of weight changes among Han primary and secondary school students in Xinjiang from 1985 to 2019
Chinese Journal of School Health 2025;46(3):416-420
Objective:
To analyze the time varying characteristics of weight among Han primary and secondary school students in Xinjiang from 1985 to 2019, so as to provide a scientific basis for formulating nutrition policies for adolescents in ethnic minority areas.
Methods:
Weight data of Han primary and secondary school students aged 7-18 in Xinjiang from the National Student Physical Fitness and Health Survey from 1985 to 2019 were selected. Statistical analysis was conducted by using general linear model test, one way ANOVA and t-test. The weight development trends in 2025 and 2030 were predicted through time series analysis.
Results:
From 1985 to 2019, the weight of Han Chinese boys and girls from primary and secondary schools in Xinjiang showed a continuous upward trend (boys: B =0.25,girls: B =0.16, P <0.01). There were statistically significant differences in weight between boys and girls aged 7-18 in different years (boys: F =102.35-142.05, girls: F =98.03-140.59, P <0.01). Compared with 1985, the weight of urban boys and girls increased by 11.92 and 7.95 kg in 2019, as well as rural boys and girls by 11.36 and 5.61 kg, and the average weight gain of urban students was greater than that of rural students. From 1985 to 2019, the weight of urban boys and girls were higher than that of rural boys and girls (boys: t =30.12-37.55, girls: t =30.12-38.64, P <0.01). In 2005, the weight difference between urban and rural boys and girls was the largest, at 4.23 and 2.32 kg. The average weight of boys and girls in the age groups of 7-18 would continue to increase in 2025 and 2030; compared with 2019, the 7-year old age group for boys and the 17-year old age group for girls would have the largest growth in 2030 by 2.29 and 3.75 kg.
Conclusions
From 1985 to 2019, the weight of students aged 7-18 in Xinjiang showed an upward trend, and the weights of both boys and girls would gradually increase in 2025 and 2030. Attention should be paid to students physical health and adopt comprehensive measures to prevente overweight and obesity.
7.Annual review of clinical research on lung transplantation of China in 2024
Xiaohan JIN ; Yixin SUN ; Jier MA ; Zengwei YU ; Yaling LIU ; Senlin HOU ; Xiangyun ZHENG ; Haoji YAN ; Dong TIAN
Organ Transplantation 2025;16(3):379-385
Lung transplantation is currently the only recognized effective treatment for end-stage lung disease and has improved the quality of life for patients. However, lung transplantation still faces many challenges, including rejection, infection, post-transplant acute kidney injury, post-transplant diabetes mellitus, ischemia-reperfusion injury and donor shortage, etc. Chinese lung transplantation scholars made a series of important progress in the field of clinical research in 2024, focusing on the study and solution of the above problems, and providing new ideas for lung transplantation surgery. This article systematically reviews the clinical research and technological innovation in the field of lung transplantation in 2024, summarizes the achievements of clinical research in the field of lung transplantation in China in 2024, and aims to providing new directions and strategies for future research.
8.Tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device in anterior mediastinal masses
Junmin ZHU ; Junjie WANG ; Jianming YUE ; Yixin SUN ; Yichen LIU ; Lei WANG ; Lin LIN ; Jie LI ; Jinlan ZHAO ; Xuehua TU ; Ningying DING ; Jianrong HU ; Chunmei HE ; Leilei TIAN ; Hongtao TANG ; Jiasheng ZHAO ; Cheng CHEN ; Yongxiang SONG ; Yunwei TIAN ; Yong XIAO ; Kaidi LI ; Lin MA ; Yun WANG ; Longqi CHEN ; Dong TIAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(11):1603-1609
Objective To assess the clinical value of a novel surgical technique—Tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device in the resection of anterior mediastinal masses. Methods Patients who underwent tubeless subxiphoid uniportal video-assisted thoracoscopic surgery via balance-shaped sternal elevation device in anterior mediastinal masses process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to April 2025 were included, and their clinical data were analyzed. Results A total of 4 patients were included, with 2 males and 2 females, aged 58-75 years. The diameter of the tumor was 2.5-3.0 cm. The operation time was 60.0-150.0 min, intraoperative blood loss was 5-10 mL, pain score on the 3rd day after surgery was 0 points, and postoperative hospital stay was 2-3 days. All patients achieved complete resection of the masses and thymus without perioperative complications. Conclusion The tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device technique optimizes surgical visualization and instrument maneuverability while avoiding complications related to conventional anesthesia and tubing, thereby markedly enhancing the minimally invasive profile of anterior mediastinal masses resections. In addition to maintaining procedural safety, this approach effectively reduces postoperative pain and accelerates patient recovery, highlighting its potential for widespread clinical adoption.
9.Competitive roles of slow/delta oscillation-nesting-mediated sleep disruption under acute methamphetamine exposure in monkeys.
Xin LV ; Jie LIU ; Shuo MA ; Yuhan WANG ; Yixin PAN ; Xian QIU ; Yu CAO ; Bomin SUN ; Shikun ZHAN
Journal of Zhejiang University. Science. B 2025;26(7):694-707
Abuse of amphetamine-based stimulants is a primary public health concern. Recent studies have underscored a troubling escalation in the inappropriate use of prescription amphetamine-based stimulants. However, the neurophysiological mechanisms underlying the impact of acute methamphetamine exposure (AME) on sleep homeostasis remain to be explored. This study employed non-human primates and electroencephalogram (EEG) sleep staging to evaluate the influence of AME on neural oscillations. The primary focus was on alterations in spindles, delta oscillations, and slow oscillations (SOs) and their interactions as conduits through which AME influences sleep stability. AME predominantly diminishes sleep-spindle waves in the non-rapid eye movement 2 (NREM2) stage, and impacts SOs and delta waves differentially. Furthermore, the competitive relationships between SO/delta waves nesting with sleep spindles were selectively strengthened by methamphetamine. Complexity analysis also revealed that the SO-nested spindles had lost their ability to maintain sleep depth and stability. In summary, this finding could be one of the intrinsic electrophysiological mechanisms by which AME disrupted sleep homeostasis.
Animals
;
Methamphetamine
;
Electroencephalography
;
Male
;
Sleep/drug effects*
;
Central Nervous System Stimulants
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Delta Rhythm/drug effects*
;
Sleep Stages/drug effects*
10.Analysis of sensitization characteristics and changing trends of common allergens in a children′s hospital in Shanghai City from 2020 to 2024
Hanhua LI ; Yazhou WU ; Yixin JIN ; Shaohua HU ; Zhan MA ; Wenhao WENG
Chinese Journal of Preventive Medicine 2025;59(6):844-856
Objective:To explore the clinical distribution characteristics and changes of common inhalant allergens and food allergens in all outpatient and inpatient children visiting Shanghai Children′s Hospital from 2020 to 2024, and to provide a basis for the diagnosis, treatment and prevention of allergic diseases in children.Methods:A retrospective cohort study was conducted to retrospectively enroll all outpatient and inpatient children who visited Shanghai Children′s Hospital and underwent serum allergen-specific IgE (sIgE) antibody testing from January 2020 to August 2024, and the characteristics and changing trends of allergens in the past 5 years were analyzed. A total of 127 310 tests were included. There were 76 776 male tests (60.31%) and 50 534 female tests (39.69%). There were 27 392 tests (21.52%) aged 0-3 years (infant group), 51 596 tests (40.53%) aged 4-6 years (preschool group), 44 574 tests (35.01%) aged 7-12 years (school-age group), and 3 748 tests (2.94%) aged 13-18 years (adolescent group). The χ2 test was used for statistical analysis. Results:The difference in total positivity rate between different years was statistically significant ( χ2=2 907.478, P<0.001). The positive rates of inhalant allergens such as house dust, Dermatophagoides pteronyssinus/ Dermatophagoides farinae, cockroach, cat dander, mugwort, Humulus scandens, mold fungi mix, and food allergens such as beef and mutton increased significantly with age (The χ2 values were 649.496, 3 414.686, 303.247, 1 277.408, 40.477, 189.952, 600.737, 203.198, and 15.301, respectively, and the P values were <0.001, <0.001, <0.001, <0.001, <0.001, <0.001,<0.001,<0.001, and 0.002, respectively). The positive rates of inhalant allergen such as Ambrosia elatior (1.59%) and food allergens such as egg white (17.36%), milk (30.48%), shrimp (8.27%), crab (8.13%), codfish (2.61%), salmon (0.66%), mytilus edulis (2.89%), lobster/scallop (5.27%), cashew nuts (5.09%), peanuts (3.54%), and soybean (1.73%) were highest at the age of 0-3 years and decreased significantly with age (The χ2 values were 10.365, 2 407.443, 139.085, 872.548, 870.245, 106.823, 47.674, 47.244, 559.422, 369.800, 384.788, 153.660, respectively, and the P values were 0.016, 0.000,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001, respectively). Inhaled allergens mainly have a greater impact on children with respiratory-related diseases such as allergic rhinitis and asthma, while food allergens mainly have a greater impact on children with atopic dermatitis/eczema. The positive rate of sIgE of various allergens in the allergic rhinitis combined asthma group were higher than that of allergic rhinitis alone, and the sIgE positive rate of total allergens and inhaled allergens was significantly higher than that of allergic rhinitis alone ( χ2=20.851, 39.155, the P values were both<0.001). Among them, the sIgE positive rate of Ambrosia elatior and cashew nuts showed significant difference ( χ2=5.044, 8.420, P=0.025, 0.004); and the sIgE positive rate of Dermatophagoides pteronyssinus/ Dermatophagoides farinae, cat dander, grass pollens mix and mold fungi mix had extremely significant difference ( χ2=26.409, 25.990, 21.283, 16.411, the P values were all <0.001). The inhaled allergens and food allergens with the highest positive rates in the 5 years were Dermatophagoides pteronyssinus/ Dermatophagoides farinae (56.21%) and milk (47.47%), and as time went by, the positive rates gradually decreased. There is a moderate correlation between the three allergens of Ambrosia elatior, Amaranthus retroflexus, and tree pollens mix (0.55, 0.70, 0.63), and there is a moderate correlation between mango and tree pollens mix (0.50). Conclusion:Dermatophagoides pteronyssinus/ Dermatophagoides farinae, cat dander, dog dander, egg white, and milk may be important allergens for children in Shanghai City from 2020 to 2024. The positive rates vary among different genders, age groups, and disease groups, but the positive rates of Dermatophagoides pteronyssinus/ Dermatophagoides farinae, milk and cat dander allergens remain in the top three.


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