Allergen immunotherapy（AIT）can alter the natural course of allergic diseases through immunomodulatory mechanisms and maintain the efficacy after completion. The induction of immune tolerance by AIT is considered to be effective treatment and the mechanism involves the participation of a variety of immune cells，including effector T cells，B cells，dendritic cells，innate lymphoid cells，mast cells and basophils. Studies have found that a variety of immune cells in peripheral blood changed during AIT treatment and the changes of some immune cells were related to the efficacy of AIT，which may provide some theoretical reference for practical clinical activities and may become potential biomarkers for predicting and evaluating the efficacy of AIT. This article reviews the changes of peripheral blood immune cells in the treatment of AIT.

Due to the limitations of current anti-HBV therapies, the HBV core (HBc or HBcAg) protein assembly modulators (CpAMs) are believed to be potential anti-HBV agents. Therefore, discovering safe and efficient CpAMs is of great value. In this study, we established a HiBiT-based high-throughput screening system targeting HBc and screened novel CpAMs from an in-house marine chemicals library. A novel lead compound 8a, a derivative of the marine natural product naamidine J, has been successfully screened for potential anti-HBV activity. Bioactivity-driven synthesis was then conducted, and the structure‒activity relationship was analyzed, resulting in the discovery of the most effective compound 11a (IC₅₀ = 0.24 μmol/L). Furthermore, 11a was found to significantly inhibit HBV replication in multiple cell models and exhibit a synergistic effect with tenofovir disoproxil fumarate (TDF) and IFNa2 in vitro for anti-HBV activity. Treatment with 11a in a hydrodynamic-injection mouse model demonstrated significant anti-HBV activity without apparent hepatotoxicity. These findings suggest that the naamidine J derivative 11a could be used as the HBV core protein assembly modulator to develop safe and effective anti-HBV therapies.

Humans ; COVID-19/genetics* ; SARS-CoV-2/genetics* ; Clustered Regularly Interspaced Short Palindromic Repeats/genetics* ; CRISPR-Cas Systems/genetics* ; RNA, Viral/genetics*

Objective:To study the respiratory morbidity and the risk factors of respiratory complications in late-preterm infants.Methods:The data of 959 late-preterm infants in 21 hospitals in Beijing from October 2015 to April 2016 were collected.These infants were divided into the respiratory morbidity group (237 cases) and the control group (722 cases) according to whether they had short-term respiratory morbidity after birth.Clinical data of the two groups were compared.Results:Among the 959 late-preterm babies, 530 were male and 429 were female.Two hundred and thirty-seven cases (24.7%) developed short-term respiratory morbidity after birth.Infectious pneumonia developed in the most cases (81 cases, 8.4%), followed by transient tachypnea (65 cases, 6.8%), amniotic fluid aspiration (51 cases, 5.3%), and respiratory distress syndrome (24 cases, 2.5%) successively.All the infants recovered and discharged.There were no differences between gender and maternal age between 2 groups (all P>0.05). Compared with the control group, more late-preterm infants were delivered by cesarean section (73.4% vs.59.7%, χ2=14.43, P<0.001) and the 1-minute Apgar score was lower [(9.41±1.66) scores vs.(9.83±0.53) scores, t=5.40, P<0.001] in the respiratory morbidity group.The differences were statistically significant.There were more cases with maternal complications in the respiratory morbidity group that in the control group (66.7% vs.58.6%, χ2=4.877, P=0.027), but no difference in various complications between 2 groups was observed ( P>0.05). In the respiratory morbidity group, the most frequent complications were maternal hypertension and preeclampsia (27.8% vs.22.6%, χ2=2.728, P=0.099). There were no differences between 2 groups in gestational age, birth weight and birth length (all P>0.05). There were more infants small for gestational age and large for gestational age in the respiratory morbidity group than in the control group (18.8% vs.14.1%, 6.3% vs.2.4%, χ2=8.960, P=0.011). The duration of hospitalization of the respiratory morbidity group was significantly longer than that of the control group [(9.00±4.42) d vs.(6.82±4.19) d, t=6.676, P<0.001] since the infants with respiratory morbidity needed to be hospita-lized. Conclusions:Respiratory diseases occur in about 1/4 of late-preterm infants.Infants who are delivered by cesarean section and whose mothers are complicated with the maternal hypertension and preeclampsia should be monitored closely.Respiratory support should be provided for infants not appropriate for gestational age who are more likely to suffer from respiratory diseases, so that they can successfully pass through the transition period.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Objective To investigate the risk factors of hyperbilirubinemia in late preterm infants. Methods The clinical data of 815 late preterm infants (449 males and 366 females) from 25 hospitals in Beijing were collected from October 2015 to April 2016, including 340 cases(41.7％) with hyperbilirubinemia (hyperbilirubinemia group), and 475 cases without hyperbilirubinemia (control group). The clinical data of two groups were compared, and the maternal factors influencing hyperbilirubinemia in late preterm infants were analyzed with logistic regression. Results There were no significant differences in gender ratio (M:F 1.39 vs. 1.12, t=1.811,P=0.172)and birth weight[(2502.6±439.6)g vs. (2470.2±402.9)g,χ2=2.330,P=0.127)]between two groups. The incidence rates of hyperbilirubinemia in infants of 34 wks, 35 wks and 36 wks of gestational age were 22.9％(87/174), 35％(119/300) and 42.1％(143/341) respectively (χ2=1.218,P=0.544). The multivariate logistic regression analysis indicated that the maternal age(OR=1.044,95％ CI:1.010-1.080,P=0.011)was independent risk factor and multiple births(OR=1.365,95％CI:0.989-1.883,P=0.048), premature rupture of membranes(OR=2.350,95％ CI:1.440-3.833,P=0.001), cesarean section(OR=1.540,95％CI:0.588-4.031,P=0.014)were risk factors for hyperbilirubinemia in late preterm infants. Conclusions The incidence of hyperbilirubinemia in late preterm infants is relatively high. Maternal age, multiple births, premature rupture of membranes and cesarean section are risk maternal factors related to hyperbilirubinemia in late preterm infants.

Objective To investigate the influence of high-fat diet on liver function and intestinal bacte-rial community through building rat models. Methods 20 rats of 21 days old were divided into two groups ran-domly as normal diet group fed with standard chow diet and high-fat group fed with high-fat diet. After 6 weeks, feces of rats in both groups were obtained for 16S rRNA high-through sequencing of the intestinal bacterial com-munity. Results After 6 weeks high-fat diet, total protein (TP) (55. 79±3. 75, P=0. 002), globin (GLB) ( 34. 9±2. 53, P<0. 001), albumin (ALB) /GLB (. 60±0. 02, P<0. 001), alkaline phosphatase (ALP) (373. 80±63. 05, P<0. 001), total cholesterol (TC) (1. 94±0. 23, P<0. 001), low density lipoprotein (LDL) (0. 76±0. 93, P<0. 001), LDL/high density lipoprotein (HDL) (1. 43±0. 22, P<0. 001), and tri-glyceride (TG) (1. 48±0. 50, P=0. 015) increased compared with the normal diet group. Additionally, intes-tinal bacterial diversity and evenness decreased significantly. The dominant bacteria were Bacteroidetes, Firmi-cutes, and Proteobacteria, with averaged relative abundances as 56. 36%, 35. 31%, and 6. 61%, respectively. The relative abundances of Bacteroidetes deceased (P=0. 007), those of Firmicutes increased (P=0. 020), and those of Proteobacteria were kept stable (P=0. 928) after a 6-week high-fat diet. Furthermore, the intesti-nal bacterial community structure changed distinctly between the two groups by 16s rRNA high-through sequen-cing. Conclusion High-fat diet can lead to change of intestinal bacterial community structure and further result in liver function damnification as well as obesity.

Objective To prospectively investigate the radiation dose and image quality of pediatric chest CT using Sn100 kV on a third-generation dual-source CT (DSCT)in comparison to standard 100 kV chest CT. Methods From December 12,2015 to June 30,2016,45 consecutive pediatric patients referred for non-contrast chest CT scan in Peking Union Medical College Hospital were prospectively enrolled as study group. They were examined at 100 kV with a dedicated tin filter on a third-generation DSCT. These patients were retrospectively matched with 45 patients who were examined on a second-generation DSCT at 100 kV without tin filter. The radiation dose as well as the lung and mediastinal window image quality(IQ)of the two groups were compared and analyzed statistically. IQ was evaluated using a five-point scale (1=unevaluable,5=excellent). Differences of radiation dose and noise between the two groups were determined with variance analysis and t test,IQ with Mann-Whitney U test,and the consistency of diagnosis with Kappa test. Results The average CT dose index volume of the study group was (0.24±0.11)mGy,which was decreased by 92% compared with the control group [(3.10+1.18)mGy] (t=16.287,P=0.000). Mean dose-length product and mean effective dose for study group were significantly lower than those of control group [(7.13±4.72)mGy·cm vs. (84.78±46.78)mGy·cm,t=11.077,P=0.000;(0.11±0.06)mSv vs.(1.23±0.61)mSv,t=12.334,P=0.000]. There was no significant difference between the two groups in terms of image noise (t=-0.003,P=0.397)and contrast to noise ratio (t=0.545,P=0.488). There was no significant difference between the two groups in lung window IQ (doctor 1:U=796.000,P=0.055;doctor 2:U=889.500,P=0.277),while significant difference was seen concerning of the mediastinal window IQ (doctor 1:U=305.000,P=0.000;doctor 2:U=276.500,P=0.000). Referring to the lung window,the median IQ for the study group and control group was 4 (3-5)and 4 (3-5),respectively. All imaging findings had acceptable IQ. The breath motion artifacts (χ=13.846,P=0.001)and heart beat artifacts (χ=53.519,P=0.000)of the study group were significantly lower than those of the control group. Conclusion Compared with standard 100 kV chest CT,the use of tin-filtered Sn100 kV on a third-generation DSCT provided 92% dose reduction in pediatric chest CT examinations while maintaining diagnostically acceptable lung window images.
Artifacts ; Child ; Feasibility Studies ; Humans ; Lung ; diagnostic imaging ; Radiation Dosage ; Radiographic Image Interpretation, Computer-Assisted ; Retrospective Studies ; Thorax ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Objective To study the early protective effect of NADPH on human umbilical vein endothelial cells (HUVECs) and the expression of occludin and MMP9 induced by oxygen glucose deprivation and reoxygenation (OGD/R). Methods HUVECs were cultured and divided into blank control group, OGD/R group and OGD/R+NADPH 20 μmol/L group. The proliferation of HUVECs after treatment was detected by CCK-8 assay. The cytotoxicity was detected by LDH release assay. The morphological changes of HUVECs were observed by inverted microscope. Superoxide dismutase (SOD MDA) activity and malondialdehyde (MDA) were detected by commercially available kit. The expressions of occludin and MMP9 were detected by Western blot assay. Results Compared with the OGD/R, NADPH enhanced the cell viability significantly (P<0.05), reduced the release of LDH (P<0.05), promoted the maintance of HUVECs morphology, reduced MDA generation (P<0.05) and increased SOD activity (P<0.05). Following OGD/R,the treatment of NADPH can inhibit MMP9 level (P<0.05) and promote the recovery of occludin level (P<0.05). Conclusion NADPH can protect HUVECs from the damage induced by OGD/R by reducing oxidative stress and regulating the expressions of MMP9 and occludin.

Objective To analyze the clinical characteristics of childhood systemic lupus erythematosus (SLE) patients with severe gastrointestinal manifestations,especially cases with acute and severe abdominal pain,so as to improve the recognition of severe and acute gastrointestinal manifestations of SLE during pediatric diagnosis and treatment.Methods Medical records of 119 patients with SLE under the age 16 years old in Peking Union Medical College Hospital from Jan.2010 to Mar.2013 were reviewed and gastrointestinal manifestations were retrospectively analyzed.All patients were diagnosed as SLE according to 1997 American College of Rheumatology (ACR) revised classification criteria.Results Gastrointestinal involvement was recorded in 24 children (20.2％).The median (range) age at the time of initial gastrointestinal manifestations was (13.5 ± 2.0) years (6-15 years).The ratio of female to male was 1.0 ∶ 2.4.And in 4 cases,gastrointestinal manifestations occurred as the initial symptoms.Abdominal pain was the most frequent symptom,present in 13 patients (54.2％),11 cases (45.8％) had nausea and vomiting,4 cases (16.6％) had abdominal distension,and 3 cases (12.5％) had diarrhea.Abnormal liver function was found by lab test in 8 cases,without obvious symptoms or the proofs of any virus infection.Acute and severe abdominal pain was found in 9 cases,of whom 6 patients were diagnosed as intestinal pseudo-obstruction (2 cases with bilateral ureterohydronephrosis),1 case had acute peritonitis with surgery,1 case was diagnosed as protein losing enteropathy and 1 case had acute pancreatitis.Liver impairment also occurred in SLE.All cases got alleviated with the treatment of steroids and immunosuppressive drugs.Significant difference was found in the occurrence of hydroureter and hydronephrosis and albumin concentrations between SLE digestive and non-digestive system involvement children.However,there was no remarkable difference in the erythrocyte sedimentation rate,or the involvement of kidney and blood system and central nervous system between the 2 groups.Conclusions SLE is a common autoimmune disease in children involving multiple systems.The severity of gastrointestinal involvement is underestimated.Gastrointestinal manifestations can be initial symptoms of SLE.Intestinal pseudo-obstruction,protein losing enteropathy,and acute pancreatitis are uncommon but severe gastrointestinal manifestations of SLE patients should be fully recognized.It is vital for pediatric physicians to make early diagnosis and begin timely treatment on SLE with Corticosteroid and cyclophosphamide.