Allergen-specific immunotherapy（AIT） remains the only therapeutic approach with the potential to modify the natural course of allergic rhinitis（AR）. Nevertheless, considerable inter-individual variability exists in patients'responses to AIT. To facilitate more reliable assessment of treatment efficacy, the China Rhinopathy Research Cooperation Group（CRRCG） convened young and middle-aged nasal experts in China to formulate the present consensus. The recommended subjective outcome measures for AIT comprise symptom scores, medication scores, combined symptom and medication scores, quality-of-life assessments, evaluation of disease control, and assessment of comorbidities. Objective indicators may supplement these measures. Currently available objective approaches include skin prick testing, nasal provocation testing, and allergen exposure chambers. However, these methods remain constrained by practical limitations and are not yet appropriate for routine implementation in clinical efficacy evaluation. In addition, several biomarkers, including sIgE and the sIgE/tIgE ratio, sIgG4, serum IgE-blocking activity, IgA, cytokines and chemokines, as well as immune cell surface molecules and their functional activity, have been shown to have associations with AIT outcomes. While these biomarkers may complement subjective assessments, they are subject to significant limitations. Consequently, large-scale multicenter trials and real-world evidence are required to strengthen the evidence base. The present consensus underscores the necessity of integrating patients'subjective experiences with objective testing throughout the treatment process, thereby providing a more comprehensive and accurate framework for efficacy evaluation. Looking forward, future investigations should prioritize the incorporation of multi-omics data and artificial intelligence methodologies, which hold promise for overcoming current limitations in assessment strategies and for advancing both the standardization and personalization of AIT.
Humans ; Allergens/immunology* ; China ; Consensus ; Desensitization, Immunologic ; Immunoglobulin E ; Quality of Life ; Rhinitis, Allergic/therapy* ; Treatment Outcome ; East Asian People

BACKGROUND:With the aging of the global population,the incidence rate of osteoporosis is also increasing.It is very important to further understand its pathogenesis and propose new therapeutic targets.Recent studies have shown that ferroptosis is closely related to the pathogenesis of some bone diseases,such as inflammatory arthritis,osteoporosis and osteoarthritis. OBJECTIVE:To summarize the previous studies on the mechanism of ferroptosis in osteoporosis,so as to provide new therapeutic ideas and potential therapeutic targets for osteoporosis. METHODS:The first author used the computer to search the documents published from 2000 to 2022 in CNKI,WanFang,VIP,PubMed and Web of Science with the key words of"ferroptosis,osteoporosis,osteoblasts,osteoclasts,iron chelators,reactive oxygen species,nuclear factor erythroid 2-related factor 2,heme oxygenase-1,glutathione peroxidase 4,review"in Chinese and English.A total of 70 articles were finally included according to the inclusion criteria. RESULTS AND CONCLUSION:Ferroptosis is significantly different from necrosis,apoptosis and autophagy.In terms of cell morphology and function,it does not have the morphological characteristics of typical necrosis,nor does it have the characteristics of traditional apoptosis,such as cell contraction,chromatin condensation,the formation of apoptotic bodies and the disintegration of cytoskeleton.Contrary to autophagy,ferroptosis does not form a classical closed bilayer membrane structure(autophagic vacuole).Morphologically,ferroptosis is mainly manifested by obvious contraction of mitochondria,increased membrane density,and reduction or disappearance of mitochondrial cristae,which are different from other cell death modes.Iron overload can destroy bone homeostasis by significantly inhibiting osteogenic differentiation and stimulating osteoclast formation,leading to osteoporosis.Iron overload interferes with the differentiation of stem cells to osteoblasts,leading to a weakened osteoblast function and further imbalance of bone metabolism in the body,which eventually leads to osteoporosis.Stimulated by iron overload,osteoclast bone resorption is enhanced and bone loss exceeds new bone formation.Iron chelators have been proved to have osteoprotective effects by inhibiting osteoclast activity and stimulating osteogenic differentiation of osteoblasts.Its potential mechanism is related to inhibiting osteoclast differentiation and promoting osteoblast differentiation.Antioxidants can prevent reactive oxygen species production and inhibit bone absorption,thus improving bone metabolism and effectively preventing osteoporosis.

OBJECTIVE:Cold water immersion methods are not standardized in terms of operational indicators such as immersion temperature,duration and depth,leading to controversy over the efficacy of recovery from exercise fatigue in skeletal muscle.In this article,we analyze the effects of cold water immersion on muscle injury,muscle soreness and muscle strength recovery under different factors,in order to find the best immersion implementation plan,and thus provide evidence for the recovery of muscle fatigue. METHODS:A search of CNKI,WanFang Data,Web of Science,and PubMed databases was conducted for relevant literature published from January 1,2000 to August 15,2023.A total of 4 759 articles were initially retrieved,with 4 735 articles excluded through screening and 24 articles finally included.The Physical Therapy Evidence Database Scale was used to assess the methodological quality of the included literature,and Stata-MP 16 software was used to perform effect size combinations,subgroup analyses,Meta-regression,sensitivity tests,and publication bias analyses. RESULTS:(1)The article included a total of 24 randomized controlled trial studies,including 617 subjects,with overall high legal quality.(2)Meta-analysis showed that cold water immersion can significantly reduce creatine kinase blood value[standardized mean difference(SMD)=-0.17,95％confidence interval(CI):-0.29 to-0.05,P<0.01],alleviate muscle pain(SMD=-0.60,95％CI:-0.81 to-0.38,P<0.01),and promote maximum muscle strength recovery(SMD=0.17,95％CI:0.05 to 0.30,P<0.01).(3)Subgroup analysis showed that:The immersing regimen with water temperature>14 ℃(SMD=-0.48,95％CI:-0.76 to-0.20,P<0.01)and duration of 12-14 minutes(SMD=-0.38,95％CI:-0.61 to-0.15,P<0.01)had the best effect in reducing creatine kinase blood values,and had a more significant intervention effect on endurance exercise(SMD=-0.45,95％CI:-0.71 to-0.20,P<0.01),while the immersion regimen with water temperature<10 ℃(SMD=-0.61,95％CI:-0.79 to-0.43,P<0.01),duration<12 minutes(SMD=-0.76,95％CI:-0.98 to-0.53,P<0.01),and immersion depth above the iliac spine(SMD=-0.74,95％CI:-0.97 to-0.52,P<0.01)had the best effect on relieving muscle soreness,and had a more significant analgesic effect after endurance exercise(SMD=-0.42,95％CI:-0.61 to-0.22,P<0.01).(4)Meta regression showed that immersion water temperature,immersion duration,and exercise type were important regulatory factors affecting the effect size of creatine kinase;immersing water temperature and immersing depth were important regulatory factors affecting the effect size of visual analogue scale score,while exercise type was an important regulatory factor affecting the maximum isometric muscle strength effect size. CONCLUSION:(1)Evidence of extremely low to moderate strength suggests that cold water immersion can effectively reduce muscle damage,alleviate muscle soreness,and promote muscle strength recovery.(2)In terms of reducing muscle injury,immersion water temperature,immersion duration,and exercise type are significant regulatory factors that affect the efficacy of immersing.Among them,immersion water temperature>14 ℃ and duration of 12-14 minutes are the best solutions to reduce muscle injury after exercise,and the immersing effect is better for endurance exercise.(3)In terms of reducing muscle soreness,immersion water temperature and immersion depth are important regulatory factors that affect the intervention effect.Among them,immersion water temperature<10 ℃,duration<12 minutes,and immersing depth above the iliac spine are the best solutions to reduce muscle soreness,and have a better analgesic effect after endurance exercise.(4)In terms of promoting muscle strength recovery,exercise type is a key regulatory factor that affects the maximum isometric muscle strength effect.

Objective:To observe the feelings of listening to music and the importance of music in the daily life of post-lingual deaf adults with cochlear implants, and to explore the relevant influencing factors.Methods:This was a cross-sectional survey study. From January 2021 to August 2021,the Music-Related Quality of Life Scale was used to evaluate the music needs and music experiences of 63 post-lingual deaf adults who met the inclusion criteria, including 27 males and 36 females, aged (40.7±12.3) years, at the time of surgery (36.8±13.1) years, and with a preoperative hearing aid ineffective time of (3.9±5.8) years. Indicators analyzed included age, duration of ineffective preoperative hearing aid wear, preoperative music preference, duration of postoperative cochlear implant use, current hearing aid modality, and auditory rehabilitation outcomes. Whether the six factors mentioned above constituted an influence on the subjects′ music listening was investigated using SPSS 25.0 statistical software.Results:All of the observations in the scale were correlated with a single factor. The two sub-dimensions of music experience section were related to the effect of auditory rehabilitation. In the importance section, the effect of auditory rehabilitation was the influential factor of the dimension of "participation importance", and the preoperative enjoyment of music was the relevant influential factor of the dimension of "perceived importance". There was a significant difference between the groups when they were grouped by the above factors ( P value<0.05), while there was no statistically significance between the groups when they were grouped by other factors ( P value>0.05). Conclusions:Post-lingual deaf adults show the need and attempt to listen to music after cochlear implantation. The effectiveness of auditory rehabilitation and the degree of music preference preoperatively are two important factors that influence music listening in implant recipients. Once the level of auditory communication has been restored to a certain degree, it is important to pay more attention to the needs of music for implant recipients and train them in time, especially for those with music preferences preoperatively.

Objective To explore the effect of adeno-associated virus sense transfection up-regulating the expression level of the growth and differential factor 11 (GDF11) in vivo on aortic injury in type 2 diabetic mellitus rats (T2DM).Methods Nine-week-old male SD rats were randomly selected to establish a T2DM model by using high-sugar and high-fat chow plus small-dose streptozotocin (STZ) combined induction.Both normal rats and dia-betic model rats were randomly divided into five groups:blank control group (Control group) , negative virus con-trol group (NC group), GDF11 adeno-associated virus group (GDF11 group), diabetic group (DM group), and diabetic + GDF11 adeno-associated virus group (DM+GDF11 group) .After 8 weeks of feeding, the serum con-centrations of insulin (INS) , advanced glycosylation end products (AGES) , recombinant growth transforming fac-tor 11 (GDF11), total cholesterol (T-CHO), triglycerides (TG), low-density lipoproteins (LDL-C), high-densi-ty lipoproteins (HDL-C) , asymmetric dimethylarginine (ADMA) , and malondialdehyde (MDA) were assayed in the rats;periodic acid-schiff stain(PAS stain) was used to observe the sites of glycogen deposition, and hematoxy-lin-eosin staining (HE) was used to observe vascular damage.Scanning electron microscopy was used to observe the damage of vascular endothelial cells and vascular elastic fibers, and protein blotting and immunohistochemistry were used to detect the expression levels of vascular injury-related proteins.Protein blotting and immunohistochem-istry were used to detect the expression levels of vascular injury-related proteins.Results The biochemical inde-xes showed that the serum concentrations of AGES, T-CHO, TG, LDL-C and MDA were higher in the DM group than those in the Control group (P<0.05), the concentrations of INS, GDF11, HDL-C and ADMA were signifi-cantly lower than those in the Control group (P<0.05) , and the concentrations of AGES and HDL-C were not sig-nificantly lower in the DM+GDF11 group compared with the DM group (P<0.05) .HDL-C was not significantly different from the DM group, and several other data were improved (P<0.05) .Pathological staining suggested that PAS staining in the DM group suggested that glycogen particles deposited in the endothelium and subendotheli-um of the aorta, HE staining observed thickening of the aortic mesentery, endothelial cells and elastic fibers broke off in an irregular alignment, and electron microscopy observed endothelial damage in the vasculature and elastic fi-bers broke off in the DM group, and these changes attenuated in the DM+GDF11 group.Protein blotting and im-munohistochemistry indicated that the expression of endothelial cell-associated proteins decreased in the DM group (P<0.05) , and mesenchymal markers elevated in the DM group (P<0.05) , these proteins were regressed in the DM+GDF11 group, and the difference was statistically significant (P <0.05).Conclusion Increasing the expression level of GDF11 in vivo can improve aortic vascular injury caused by diabetes mellitus, which is inferred that it may be related to the inhibition of endothelial mesenchymal transition to protect the function of vascular endo-thelial cells and thus improve vascular injury.

Objective:To establish a polymerase chain reaction(PCR)method to accurately discriminate the crude materials and aqueous extract of Zaocys dhumnades,Elaphe carinata,Elaphe meollendorff and Ptyas korros.Methods:Specific primers were designed using mitochondrial Cytb gene(CO1)as a target gene,and annealing temperature,number of cycles and the type of DNA polymerases were optimized.The mixed samples were detected by this method.Results:By this multiplex allele-specific PCR identification method,135,182,246 and 197 bp of specific fragments were amplified from DNA templates of Zaocys dhumnades,Elaphe carinata,Elaphe meollendorffi and Ptyas korros,respectively,following the conditions:cycle number of 35,annealing temperature of 62 ℃.The adulterants and the blank control showed no bands.The method could simultaneously and accurately identify the snake-derived components in the mixed samples.Conclusion:The method can be used to identify the samples of Zaocys dhumnades,Elaphe carinata,Elaphe meollendorffi and Ptyas korros simultaneously,accurately and rapidly,and is suitable for the identification of standard decoctiond and formula granules samples.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective:To investigate the psychological feelings of parents of children with fracture of ulna and radius during radiological examination, and to provide the basis for taking scientific and effective intervention program.Methods:Using the purposive sampling methods, a total of 30 parents of children who were treated in the pediatric orthopedics department of the emergency department of Beijing Jishuitan Hospital affiliated to Capital Medical University from January 2022 to June 2023 were selected as the research objects. A descriptive research method was adopted to conduct semi-structured interviews with parents of children, and Colaizzi′s phenomenological analysis was applied to analyze, refine, and summarize the interview information.Results:Four themes were summarized: negative emotions, information needs, seeking multi-party support and post-traumatic growth.Conclusions:The medical staff should pay close attention to the psychological status of the parents, meet their needs for information during the radiological examination, and provide targeted support measures to promote the prognosis of the children, improve the psychological adjustment and quality of life of the children and their parents.

Purpose: Knowing the distinction between benign and borderline/malignant phyllodes tumors (PTs) can help in the surgical treatment course. Herein, we investigated the value of magnetic resonance imaging-based texture analysis (MRI-TA) in differentiating between benign and borderline/malignant PTs. Methods: Forty-three women with 44 histologically proven PTs underwent breast MRI before surgery and were classified into benign (n = 26) and borderline/malignant groups (n = 18 [15 borderline, 3 malignant]). Clinical and routine MRI parameters (CRMP) and MRI-TA were used to distinguish benign from borderline/malignant PT. In total, 298 texture parameters were extracted from fat-suppression (FS) T2-weighted, FS unenhanced T1-weighted, and FS first-enhanced T1-weighted sequences. To evaluate the diagnostic performance, receiver operating characteristic curve analysis was performed for the K-nearest neighbor classifier trained with significantly different parameters of CRMP, MRI sequence-based TA, and the combination strategy. Results: Compared with benign PTs, borderline/malignant ones presented a higher local recurrence (p = 0.045); larger size (p < 0.001); different time-intensity curve pattern (p = 0.010); and higher frequency of strong lobulation (p = 0.024), septation enhancement (p = 0.048), cystic component (p = 0.023), and irregular cystic wall (p = 0.045). TA of FS T2-weighted images (0.86) showed a significantly higher area under the curve (AUC) than that of FS unenhanced T1-weighted (0.65, p = 0.010) or first-enhanced phase (0.72, p = 0.049) images. The texture parameters of FS T2-weighted sequences tended to have a higher AUC than CRMP (0.79, p = 0.404). Additionally, the combination strategy exhibited a similar AUC (0.89, p = 0.622) in comparison with the texture parameters of FS T2-weighted sequences. Conclusion MRI-TA demonstrated good predictive performance for breast PT pathological grading and could provide surgical planning guidance. Clinical data and routine MRI features were also valuable for grading PTs.

Objective:To explore the application of OTD (observation, teaching and discussion) teaching combined with clinical pathway in nursing standardized training in operating room.Methods:A total of 50 nurses who were trained in the Operating Room of The First Affiliated Hospital of Air Force Medical University from August 2017 to June 2020 were selected and divided into control group and study group according to the rotation order, with 25 nurses in each group. Traditional teaching was used in the control group, and OTD teaching combined with clinical pathway was used in the study group. After the rotation training, the teaching effect was evaluated through the assessment of theoretical knowledge and clinical practice comprehensive ability, teaching satisfaction, and the satisfaction scores of participating surgeons and patients. SPSS 22.0 was used for t-test and chi-square test. Results:The results of theoretical assessment, clinical skill assessment and comprehensive ability assessment of operating room of the rotating nurses in the study group were higher than those in the control group, with significant difference ( P < 0.05). The study group was significantly better than the control group in 8 aspects, including learning initiative, stimulating learning interest, problem-solving ability, communication ability, clinical thinking ability, teamwork ability, critical thinking ability and teaching satisfaction ( P<0.05). The satisfaction scores of doctors [(94.06±2.67) vs. (92.17±2.75)] and patients [(94.90±3.22) vs. (91.25±3.10)] in the study group were significantly higher than those in the control group ( P<0.05). Conclusion:OTD teaching combined with clinical pathway can help to improve the theoretical knowledge, clinical practice comprehensive skills and teaching satisfaction of nursing students in operating room, and then improve the teaching quality.