ObjectiveTo observe the clinical efficacy and safety of Tianmeng Lingjiao Formula（天礞羚角方， TLF） as an adjunctive therapy for paroxysmal atrial fibrillation （PAF） with phlegm-heat harassing the interior syndrome. MethodsNinety patients with PAF and phlegm-heat harassing the interior syndrome were enrolled and randomly assigned in a 2∶1 ratio to test group （60 cases） and control group （30 cases）. The control group received conventional western medicine， while the test group received TLF in addition to the conventional treatment， with one dose administered daily. The treatment course for both groups was 4 weeks. The efficacy of traditional Chinese medicine （TCM） syndrome and the rate of atrial fibrillation （AF） conversion were compared between groups. Assessments included AF burden， frequency and duration of AF episodes， TCM syndrome scores， and European Heart Rhythm Association （EHRA） AF symptom classification before and after treatment. Safety indicators such as blood routine， urine routine， stool routine， liver function， kidney function， and electrolytes were also monitored. Adverse events were recorded. ResultsA total of 82 patients completed the study （54 in the test group and 28 in the control group）. After treatment， AF burden， the frequency and duration of AF episodes， and TCM syndrome scores were significantly reduced in both groups， and the test group showed lower indicators than the control group （P＜0.01 or P＜0.05）. The AF conversion rate was 25.93% （14/54） in the test group， significantly higher than 3.57% （1/28） in the control group （P＜0.05）. The total effective rate for TCM syndrome efficacy was 83.33% （45/54） in the test group， which was significantly higher than 67.86% （19/28） in the control group （P＜0.05）. After treatment， the EHRA atrial fibrillation symptom severity in the test group showed significant improvement， and the improvement in atrial fibrillation symptoms was superior to that in the control group （P＜0.01or P＜0.05）. No significant abnormalities were observed in safety indicators， and no adverse events occurred during the trial. ConclusionTLF as an adjunctive therapy can reduce AF burden， enhance the conversion rate of AF， decrease the frequency and duration of episodes， and improve clinical symptoms in patients with paroxysmal atrial fibrillation presenting with phlegm-heat harassing the interior syndrome， with a favorable safety profile.

Objective:To investigate the prenatal echocardiographic features of fetuses diagnosed with Ebstein anomaly (EA), identify prognostic factors affect the fetal and neonatal mortality, and evaluate the clinical value of the Simpson Andrews Sharland prognostic score (SAS prognostic score).Methods:A retrospective cohort study was conducted on 37 fetuses diagnosed with EA via prenatal and postnatal echocardiography at Guangdong Provincial People′s Hospital from June 2012 to June 2024. The echocardiographic features of EA patients were summarized. According to the patients′ survival statuses during the fetal and neonatal periods, they were divided into survival group and death group for a comparative analysis of key echocardiographic parameters, as well as SAS prognostic score. Also, receiver operator characteristic (ROC) curve was employed to assess the predictive abilities of various indicators. Finally, based on the medium-and long-term prognostic outcomes of EA cases, the predictive value of the SAS system was evaluated. The t test, Mann-Whitney U test, and Fisher exact test were used for group comparison. Results:Regarding the 37 EA cases, the gestational age at the initial diagnosis was (29±4) weeks. All of EA fetuses exhibited echocardiographic characterized by tricuspid regurgitation (TR) originating below the native tricuspid annulus with the severity varied, accompanied by manifestations such as right atrial enlargement. Of all cases, 5 cases (14%) died prenatally, and 32 cases (86%) were born alive. Postnatally, 4 cases died preoperatively, 1 case died postoperatively, and 27 cases survived. Compared with the survival group, the death group had a significantly higher average SAS prognostic score (6.9±1.1 vs. 2.0±1.5, t=9.17, P<0.001), right atrium (RA) to left atrium (LA) transverse diameter ratio (2.0±0.5 vs. 1.3±0.2, t=4.87, P=0.001) and TR area to RA area ratio (0.8±0.2 vs. 0.4±0.2, t=5.27, P<0.001). According to the ROC analysis, the optimal predictive value indicators are RA to LA transverse diameter ratio (AUC=0.93, 95% CI 0.81-1.00) and the TR area-to-RA area ratio (AUC=0.93, 95% CI 0.85-1.00); the optimal cut-point values were 1.5 and 0.5, respectively. Of 32 born alive cases, 21 cases (66%) didn′t undergo surgery, 2 cases (6%) underwent bidirectional Glenn surgery, and one case (3%) underwent tricuspid valvuloplasty. All 17 cases with SAS score≤2 survived, while all 9 cases with SAS score≥6 died. Among the 11 cases with a score from 3 to 5, 8 cases achieved a biventricular outcome. Conclusions:The typical echocardiographic feature of EA fetuses is that the originating point of TR is below the native tricuspid annulus and the severity can vary. The SAS score is essential for tiered prognosis. When the SAS is 3-5, dynamic monitoring for TR and RA enlargement should be employed to help guide prenatal intervention and reduce fetal and neonatal mortality.

Objective:To investigate the prenatal echocardiographic features of fetuses diagnosed with Ebstein anomaly (EA), identify prognostic factors affect the fetal and neonatal mortality, and evaluate the clinical value of the Simpson Andrews Sharland prognostic score (SAS prognostic score).Methods:A retrospective cohort study was conducted on 37 fetuses diagnosed with EA via prenatal and postnatal echocardiography at Guangdong Provincial People′s Hospital from June 2012 to June 2024. The echocardiographic features of EA patients were summarized. According to the patients′ survival statuses during the fetal and neonatal periods, they were divided into survival group and death group for a comparative analysis of key echocardiographic parameters, as well as SAS prognostic score. Also, receiver operator characteristic (ROC) curve was employed to assess the predictive abilities of various indicators. Finally, based on the medium-and long-term prognostic outcomes of EA cases, the predictive value of the SAS system was evaluated. The t test, Mann-Whitney U test, and Fisher exact test were used for group comparison. Results:Regarding the 37 EA cases, the gestational age at the initial diagnosis was (29±4) weeks. All of EA fetuses exhibited echocardiographic characterized by tricuspid regurgitation (TR) originating below the native tricuspid annulus with the severity varied, accompanied by manifestations such as right atrial enlargement. Of all cases, 5 cases (14%) died prenatally, and 32 cases (86%) were born alive. Postnatally, 4 cases died preoperatively, 1 case died postoperatively, and 27 cases survived. Compared with the survival group, the death group had a significantly higher average SAS prognostic score (6.9±1.1 vs. 2.0±1.5, t=9.17, P<0.001), right atrium (RA) to left atrium (LA) transverse diameter ratio (2.0±0.5 vs. 1.3±0.2, t=4.87, P=0.001) and TR area to RA area ratio (0.8±0.2 vs. 0.4±0.2, t=5.27, P<0.001). According to the ROC analysis, the optimal predictive value indicators are RA to LA transverse diameter ratio (AUC=0.93, 95% CI 0.81-1.00) and the TR area-to-RA area ratio (AUC=0.93, 95% CI 0.85-1.00); the optimal cut-point values were 1.5 and 0.5, respectively. Of 32 born alive cases, 21 cases (66%) didn′t undergo surgery, 2 cases (6%) underwent bidirectional Glenn surgery, and one case (3%) underwent tricuspid valvuloplasty. All 17 cases with SAS score≤2 survived, while all 9 cases with SAS score≥6 died. Among the 11 cases with a score from 3 to 5, 8 cases achieved a biventricular outcome. Conclusions:The typical echocardiographic feature of EA fetuses is that the originating point of TR is below the native tricuspid annulus and the severity can vary. The SAS score is essential for tiered prognosis. When the SAS is 3-5, dynamic monitoring for TR and RA enlargement should be employed to help guide prenatal intervention and reduce fetal and neonatal mortality.

Objective The aim of this study was to analyze the value of quantitative parameters of dynamic contrast en-hanced magnetic resonance imaging(DCE-MRI)combined with the detection of non-SMC condensing Ⅰ complex subunit H(NCAPH)in the diagnosis of early breast cancer.Methods Ninety-six patients with breast nodules who were treated in the depart-ment of Breast Surgery at Longgang District Maternity&Child Healthcare Hospital in Shenzhen from March 2020 to March 2022 were selected as the study objects.DCE-MRI examination was performed on all patients,and transport constant(Ktrans)and rate constant(Kep)were recorded.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was used to detect the expression of serum NCAPH mRNA.Based on the results of pathological examination as the gold standard,the patients with breast nodules diag-nosed pathologically as the benign group and the patients with breast cancer as the breast cancer group,the differences of DCE-MRI quantitative parameters Ktrans,Kep and serum NCAPH mRNA between the benign group and the breast cancer group were compared.The accuracy,sensitivity and specificity of serum NCAPH mRNA and their combination in the diagnosis of early breast cancer were different.Kappa test was used to compare the consistency with the pathological results.Results The results of pathological examina-tion confirmed that there were 31 benign nodules and 65 breast cancer in 96 patients with breast nodules.Ktrans,Kep and NCAPH mRNA in the breast cancer group were significantly higher than those in the benign group(P<0.05);The AUC of Ktrans,Kep and NCAPH in the diagnosis of early breast cancer was 0.944,which was significantly higher than that of Ktrans and Kep alone,with the sensitivity and specificity of 96.92% and 77.42% ,respectively;Ktrans and Kep combined with NCAPH detected 7 false positives and 2 false negatives,with a Kappa value of 0.776(P<0.05),which was consistent with the pathological results;The sensitivity of DCE-MRI quantitative parameters combined with NCAPH in the diagnosis of early breast cancer was significantly higher than that of DCE-MRI quantitative parameters and serum NCAPH alone(P<0.05).Conclusion The expression of Ktrans,Kep and serum NCAPH mRNA in breast cancer patients with DCE-MRI quantitative parameters is high.Ktrans,Kep combined with serum NCAPH detection has certain clinical values in the diagnosis of early breast cancer.

Objective The aim of this study was to analyze the value of quantitative parameters of dynamic contrast en-hanced magnetic resonance imaging(DCE-MRI)combined with the detection of non-SMC condensing Ⅰ complex subunit H(NCAPH)in the diagnosis of early breast cancer.Methods Ninety-six patients with breast nodules who were treated in the depart-ment of Breast Surgery at Longgang District Maternity&Child Healthcare Hospital in Shenzhen from March 2020 to March 2022 were selected as the study objects.DCE-MRI examination was performed on all patients,and transport constant(Ktrans)and rate constant(Kep)were recorded.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was used to detect the expression of serum NCAPH mRNA.Based on the results of pathological examination as the gold standard,the patients with breast nodules diag-nosed pathologically as the benign group and the patients with breast cancer as the breast cancer group,the differences of DCE-MRI quantitative parameters Ktrans,Kep and serum NCAPH mRNA between the benign group and the breast cancer group were compared.The accuracy,sensitivity and specificity of serum NCAPH mRNA and their combination in the diagnosis of early breast cancer were different.Kappa test was used to compare the consistency with the pathological results.Results The results of pathological examina-tion confirmed that there were 31 benign nodules and 65 breast cancer in 96 patients with breast nodules.Ktrans,Kep and NCAPH mRNA in the breast cancer group were significantly higher than those in the benign group(P<0.05);The AUC of Ktrans,Kep and NCAPH in the diagnosis of early breast cancer was 0.944,which was significantly higher than that of Ktrans and Kep alone,with the sensitivity and specificity of 96.92% and 77.42% ,respectively;Ktrans and Kep combined with NCAPH detected 7 false positives and 2 false negatives,with a Kappa value of 0.776(P<0.05),which was consistent with the pathological results;The sensitivity of DCE-MRI quantitative parameters combined with NCAPH in the diagnosis of early breast cancer was significantly higher than that of DCE-MRI quantitative parameters and serum NCAPH alone(P<0.05).Conclusion The expression of Ktrans,Kep and serum NCAPH mRNA in breast cancer patients with DCE-MRI quantitative parameters is high.Ktrans,Kep combined with serum NCAPH detection has certain clinical values in the diagnosis of early breast cancer.

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.
Adult ; Asian Continental Ancestry Group* ; China ; Comorbidity ; Developed Countries ; Developing Countries ; Diagnosis* ; Epidemiologic Studies ; Epidemiology ; Global Health ; Humans ; Hypersensitivity* ; Prevalence ; Rhinitis, Allergic*