Objective:To investigate the anatomic origin of juvenile nasopharyngeal angiofibroma（JNA） through radiologic analysis of tumor invasion patterns, providing insights into tumor etiology and surgical recurrence prevention. Methods:This retrospective cohort study included primary JNA cases at the Department of Otorhinolaryngology, Eye and ENT Hospital of Fudan University from March 2015 to September 2024. All patients underwent preoperative high-resolution CT（HRCT） scans, and some underwent enhanced magnetic resonance imaging. The study retrospectively analyzed the patients' imaging data to examine tumor invasion into the pterygopalatine fossa and the vidian canal. These sites were categorized into non-invaded, partially invaded, and completely invaded for the pterygopalatine fossa and the vidian canal. The study analyzed the proportions of invasion at these sites to further speculate on the origin of JNA. Results:A total of 105 JNA patients were included in the study. Among them, 100% of the patients had complete tumor invasion in the pterygopalatine fossa. For the vidian canal, the proportions of complete invasion, partial invasion, and non-invasion were 54.3%, 27.6%, and 18.1%, respectively. As the staging of JNA tumors increased, the proportion of vidian canal invasion also increased. Conclusion:Our evidence suggests that the pterygopalatine fossa, rather than the vidian canal, might be the likely origin of JNA, which is enlightening for the study of the etiological mechanisms of JNA.
Humans ; Nasopharyngeal Neoplasms/pathology* ; Retrospective Studies ; Angiofibroma/pathology* ; Neoplasm Invasiveness ; Pterygopalatine Fossa/pathology* ; Female ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed ; Adolescent

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

PURPOSE: Recent evidence suggests that B cells can both promote and inhibit the development and progression of allergic disease. However, the characteristics of B cell subsets in patients with allergic rhinitis (AR) have not been well documented. This study aimed to analyze the characteristics of B cell subsets in the peripheral blood of AR patients. METHODS: Forty-seven AR patients and 54 healthy controls were enrolled in this study, and the B cell subsets in peripheral blood of all subjects were analyzed by flow cytometry. Moreover, the serum total immunoglobulin E (IgE) and IgE concentrations secreted into the cultured peripheral blood mononuclear cells (PBMCs) were measured by using enzyme-linked immunosorbent assay. RESULTS: We found the peripheral blood of AR patients contained higher percentages of memory B cells, plasma cells, and CD19+CD24hiCD27+ regulatory B cells (Bregs) than those of age-matched healthy controls (P < 0.05), while the percentages of naïve B cells and CD19+CD24hiCD38hi Bregs were significantly lower in AR patients than in healthy individuals (P < 0.05). In addition, the serum total IgE and IgE concentrations secreted into the cultured PBMCs were elevated in AR patients than in the healthy controls (P < 0.05). CONCLUSIONS: Our findings indicate that AR patients were characterized by increase in terminally differentiated memory B cells or plasma cells and decreases in CD19+CD24hiCD38hi Breg cells in the peripheral blood.
B-Lymphocyte Subsets* ; B-Lymphocytes ; B-Lymphocytes, Regulatory ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Humans ; Immunoglobulin E ; Immunoglobulins ; Memory ; Plasma Cells ; Rhinitis, Allergic*

Objective To understand and analysis of the pathogens distribution and drug resistance of nosocomial infection in children′s hospital,so as to provide reliable scientific basis for the prevention and control of hospital infection.Methods 396 cases of upper respiratory tract specimens were collected from pediatric patients with nosocomial infection.These specimens were detected by sputum specimens conventional methods of microorganism cultivation,and K-B method was used to determine the bacteria sensi-tivities to clinical common drug.Results There were 225 cases of specimens were pathogen positive among all the 396 specimens, and 234 strains of bacteria were isolated in all.The positive isolated rate was 56.8%(225/396).Among the 234 isolated strains, Gram negative bacteria accounted for 72.6%(170/234),and Klebsiella occupied the first place[49.4%(84/170)].Gram positive bacteria accounted for 23.5%(55/234),and Staphylococcus had the highest isolated rate in Gram positive bacteria[58.2% (32/55)].In all the 9 kinds of clinical common antimicrobial agents,imipenem had high drug sensitivity to the 234 isolated strains,and the aminoglycosides came next.Conclusion It is necessary for the pediatric patients with nosocomial infection to collect upper re-spiratory tract specimens for bacteriologic studies and drug sensitivity tests.

Objective To investigate the optimum reperfusion duration of liver ischemia-reperfusion injury (IRI) model by occluding the proper hepatic artery in rats. Methods Fourty-eight Sprague Dawley (SD) rats with mean weight of (200±25) g were randomly assigned to 8 groups by random number table method:IRI-0, 1, 3, 6, 12, 24, 48 h and sham operation (SO) group with 6 rats in each group. The proper hepatic arteries in rats of IRI groups were selectively occluded for 1 h and then blood lfow recovered. Samples of blood and liver tissues were collected at the time points of 0, 1, 3, 6, 12, 24, 48 h of reperfusion. In SO group, samples were collected after the proper hepatic artery was isolated and the ifrst portal was exposed for 1 h. The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), pathological changes, DNA fragmentation rates, and levels of Ki-67 expression of liver tissues were observed in each group. Measurement data of multiple groups were compared using one-way analysis of variance and LSD-t test. Results The levels of serum ALT in IRI-0, 1, 3, 6, 12, 24, 48 h and SO group were (53±25), (85±20), (96±18), (411±96), (87±19), (81±15), (46±6), (60±14) U/L respectively. The levels of serum AST were (238±63), (364±111), (375±68), (1 291±511), (800±87), (854±218), (484±219), (248±94) U/L accordingly. The levels of serum ALT, AST in IRI 6 h group were the highest (F=36.015, 18.241;P<0.05). The damage of liver tissues in IRI 6 h group was the most serious. The DNA fragmentation rates of liver tissues were (7.5±1.5)%, (9.2±2.2)%, (9.3±2.3)%, (12.6±2.4)%, (6.3±1.0)%, (5.4±0.9)%, (4.5±0.8)%, (4.5±1.1)%accordingly, which was the highest in IRI 6 h group (F=15.992, P<0.05). The levels of Ki-67 expression of liver tissues were (3.5±1.4), (5.6±1.8), (8.7±2.3), (13.7±2.4), (15.2±1.2), (20.5±2.2), (31.8±2.5), (2.4±1.2)/high power ifeld accordingly, which was the highest in IRI 48 h group (F=261.707, P<0.05). Conclusions The liver IRI model can be successfully established by occluding the proper hepatic artery, and the optimum reperfusion duration of IRI is 6 h.