Objective This case report describes the treatment of a patient with J-wave syndrome who experienced two cardiac arrests and discusses the potential role of mild hypothermia in cardiopulmonary and cerebral resuscitation.Methods A patient with J-wave syndrome was admitted to the department of emergency of Qingpu Branch of Zhongshan Hospital Affiliated with Fudan University.During the treatment,mild hypothermia was adopted for brain protection.The patient suffered cardiac arrest again in the hospital.After continuous cardiopulmonary resuscitation(CPR)for 230 minutes under mild hypothermia,sinus rhythm was restored.By sharing the diagnostic approach and treatment process,valuable insights can be gained to improve patient outcomes in similar cases.Results A 17-year-old female patient was admitted to department of emergency of Qingpu Branch of Zhongshan Hospital Affiliated with Fudan University on September 30,2021 due to sudden loss of consciousness for 30 minutes after running.She fainted 3 times in the past after excise and nervousness.CPR was performed immediately after the syncope,and an ambulance arrived at the scene 10 minutes later,and electrical defibrillation and tracheal intubation mechanical ventilation were conducted.When admitted to the intensive care unit(ICU),the patient continued to have tetanic convulsions.To manage these symptoms,the medical team administered sedation and anti-epileptic treatment while focusing on maintaining internal environment stability.Additionally,mild hypothermia treatment was initiated,controlling the patient's core body temperature at 34-36℃.With these interventions,the tetanic convulsions gradually subsided during the night.At 11:40 on October 1,the electrocardiogram(ECG)monitoring indicated ventricular fibrillation,and immediate rescue efforts such as CPR,electrical defibrillation,and blood pressure elevation were given.Due to recurrent ventricular fibrillation,the patient underwent repeated shock defibrillation and chest compressions with the CPR machine.Antiarrhythmic lidocaine was administered,and epinephrine and isoproterenol were administered to maintain the heart rate above 90 bpm.At around 15:30,the heart rate stabilized and blood pressure gradually improved.After successful resuscitation,mild hypothermia and other brain protection treatment were continued.On October 4,the mind was cleared,the muscle strength was restored to normal and the tracheal intubation was removed on October 6.Holter electrocardiogram examination indicated V1-V3 ST-segment elevation,combined with the patient's history of repeated syncope,previous electrocardiogram indicated early repolarization,considering the possibility of J-wave syndrome and Brugada syndrome,the patient was discharged after implantable cardioverter defibrillator(ICD)installation.Conclusions In this case,the patient was successfully resuscitated after two cardiac arrests.Among them,CPR after cardiac arrest in hospital was successfully performed for a long time under mild hypothermia without any neurological sequelae.The treatment experience provided a reference for clinical cardiopulmonary and brain resuscitation.

Objective:To analyze the genetic and environmental factors that may contribute to the development of allergic rhinitis (AR) in patients, and provide a scientific basis for formulating intervention measures.Methods:This is a case-control study. A cross-sectional survey was conducted on AR patients who received treatment at The First Affiliated Hospital of Nanchang University from June 2017 to March 2019 using a self-designed questionnaire on AR susceptibility factors. Logistic regression analysis of AR susceptibility factors was performed.Results:There were 242 patients in the AR group and 258 patients in the non-AR group (control group). The average age of all patients was (13.16 ± 5.63) years. 56.8% of included patients were male. Multivariate logistic regression analysis showed that AR onset was associated with neonatal jaundice ( OR = 6.043), respiratory infections within 6 months after birth ( OR = 8.123), diarrhea ( OR = 3.868), eczema ( OR = 4.540), living in urban areas ( OR = 2.477), home decoration after birth ( OR = 3.042), moldy ceilings or walls ( OR = 38.255), home gardening ( OR = 3.752), and exposure to smoking environments ( OR = 2.574). Conclusion:The etiology of AR is complex, and its onset is influenced by various factors such as genetic factors, environmental factors, and related disease factors. It is necessary to strengthen the promotion and education of AR prevention knowledge, pay attention to environmental hygiene, and take personal protection measures.

Objective:To compare the clinical value of visual analogue scale （VAS）, Lebel scale and total nasal symptom scores （TNSS） in evaluating nasal allergen provocation test （NAPT）. Methods:A total of 151 patients suspected of allergic rhinitis admitted to the Department of Otolaryngology-Head and Neck Surgery of our hospital from April 2020 to September 2020 were included, of which 76 were positive for house dust mites and 75 were negative for allergens. Nasal airway resistance（NAR） was measured by active anterior nasal manometry. Nasal symptoms were evaluated by VAS, Lebel and TNSS. House dust mite allergen was used for NAPT by spray method. An increase≥40% in NAR was used as the gold standard for objective evaluation of NAPT. ROC curves of VAS, Lebel and TNSS were drawn to compare the evaluation effectiveness of different subjective evaluation methods, and the optimal critical point of each ROC curve was obtained. Results:With NAR increased by ≥40% as the gold standard, the area under ROC curve of VAS was 0.884, and the sensitivity and specificity were 97.75% and 80.65%, respectively. The area under ROC curve of Lebel was 0.773, and the sensitivity and specificity were 68.54% and 75.81%, respectively. The area under ROC curve of TNSS was 0.792, and the sensitivity and specificity were 68.54% and 79.03%, respectively. There was no significant difference between Lebel and TNSS（P>0.05）. The VAS differed significantly from Lebel and TNSS（P<0.05）. The Kappa values of VAS, Lebel, TNSS and NAR were 0.803, 0.432 and 0.459, respectively. Conclusion:The VAS, Lebel, TNSS subjective scale and NAR are consistent in evaluating the efficacy of NAPT, with the VAS assessment showing highest consistency with NAR. As objective assessment instruments are not widely used in China, subjective assessment method could be adopted to evaluate the efficacy of NAPT in clinical practice, and VAS scale is recommended as a priority.
Animals ; Humans ; Allergens ; Nasal Provocation Tests/methods* ; Rhinitis, Allergic/diagnosis* ; Nose ; Pyroglyphidae

Objective:To explore the relationship of sleep quality and sleep duration with hypertension among adults aged 30-79 years old in Guangzhou.Methods:According to multi-stage stratified cluster sampling, 12 747 residents aged 30-79 years old were sampled and surveyed in Guangzhou from January 2018 to March 2019. Data on general demographic characteristics, sleep quality, sleep duration and hypertension were collected through questionnaire survey, the Pittsburgh sleep quality index (PSQI) and physical examination. Multivariate logistic regression models were used to analyze the putative association between sleep quality, sleep duration and hypertension. Restrictive cubic spline curve was used to draw the dose-response relationship curve between sleep quality, sleep time and hypertension.Results:The mean age of the subjects was (52.68±12.17) years, the prevalence of hypertension was 36.6% (4 664/12 747), the average score of PSQI was (4.70±2.88), and the average sleep time was (7.00±1.32) hours. The prevalence of hypertension was positively associated with the PSQI score. Compared to the subjects with a score less than 3, OR (95% CI) of hypertension with a PSQI score of 3-5, 5-8, ≥9 were 1.14 (1.02-1.27), 1.17 (1.03-1.34), 1.41 (1.21-1.64), respectively. The relationship between sleep duration and hypertension appeared U-shaped. Compared with 6 to 8 hours sleep duration, both sleep duration<6 hours with OR(95% CI) of 1.27(1.12-1.43) or >8 hours with OR(95% CI) of 1.20(1.05-1.38) was associated with hypertension. Conclusion:Both poor sleep quality, longer or shorter sleep duration were responsible for increased risk of cognitive impairment in older Chinese.

Objective:To explore the relationship of sleep quality and sleep duration with hypertension among adults aged 30-79 years old in Guangzhou.Methods:According to multi-stage stratified cluster sampling, 12 747 residents aged 30-79 years old were sampled and surveyed in Guangzhou from January 2018 to March 2019. Data on general demographic characteristics, sleep quality, sleep duration and hypertension were collected through questionnaire survey, the Pittsburgh sleep quality index (PSQI) and physical examination. Multivariate logistic regression models were used to analyze the putative association between sleep quality, sleep duration and hypertension. Restrictive cubic spline curve was used to draw the dose-response relationship curve between sleep quality, sleep time and hypertension.Results:The mean age of the subjects was (52.68±12.17) years, the prevalence of hypertension was 36.6% (4 664/12 747), the average score of PSQI was (4.70±2.88), and the average sleep time was (7.00±1.32) hours. The prevalence of hypertension was positively associated with the PSQI score. Compared to the subjects with a score less than 3, OR (95% CI) of hypertension with a PSQI score of 3-5, 5-8, ≥9 were 1.14 (1.02-1.27), 1.17 (1.03-1.34), 1.41 (1.21-1.64), respectively. The relationship between sleep duration and hypertension appeared U-shaped. Compared with 6 to 8 hours sleep duration, both sleep duration<6 hours with OR(95% CI) of 1.27(1.12-1.43) or >8 hours with OR(95% CI) of 1.20(1.05-1.38) was associated with hypertension. Conclusion:Both poor sleep quality, longer or shorter sleep duration were responsible for increased risk of cognitive impairment in older Chinese.

Objective To investigate the correlation of the expressions of advanced glycation end products(AGE) and the receptor for advanced glycation end products(RAGE) in serum and placenta with the pathogenesis of preeclampsia. Methods From December 2013 to June 2014, 32 women with severe preeclampsia who received cesarean section in the Affiliated Hospital of Qingdao University were recruited in the study, defined as the severe preeclampsia group. 30 healthy pregnant women who received cesarean section in the same hospital were recruited as the control group. ELISA was used to measure the maternal serum AGE, soluble receptor for advanced glycation end products (sRAGE) and tumor necrosis factor-α(TNF-α) in these women. Furthermore, ELISA was also used to measure AGE and TNF-α in the placenta. The localizations of AGE and RAGE protein in placentas were detected by immunohistochemical SP method. RAGE and TNF-α mRNA expression in placentas were measured by real-time quantitative PCR. AGE, RAGE and TNF-αprotein expression in placentas were measured by western blot, respectively. Results (1) The serum levels of AGE,sRAGE and TNF-αin the severe preeclampsia group were (538 ± 75),(367 ± 86) and (322 ± 40) ng/L,respectively. They were significantly higher than those in the control group[(454 ± 50), (286 ± 35) and (270 ± 35) ng/L, respectively](P<0.05). The levels of AGE showed positive correlation with the levels of TNF-α(r=0.588,P<0.05),while the levels of sRAGE showed no correlation with TNF-α(r=-0.041, P>0.05). (2) In the severe preeclampsia group, the levels of AGE and TNF-αin placentas were (500 ± 82) and (334 ± 57) ng/L, which were higher than those in the control group [(431 ± 74) and (263 ± 46) ng/L, respectively](P<0.05). The levels of AGE showed positive correlation with the levels of TNF-ɑ(r=0.406,P<0.05). (3)AGE and RAGE protein mainly located in the syncytiotrophoblasts, macrophages and vascular endothelial cells in the placentas of the two groups. AGE expressed mainly in the cytoplasm, and RAGE expressed in the cytoplasm and cell membranes.(4)RAGE and TNF-αmRNA expression in the placentas of the severe preeclampsia group were 12.6 ± 4.6 and 10.4 ± 2.4, which were significantly higher than those in the control group (0.9 ± 0.4 and 3.5 ± 0.9,P<0.01). (5) The expressions of AGE、RAGE and TNF-αprotein in placentas of the severe preeclampsia group were 0.68 ± 0.06, 0.82 ± 0.08 and 0.76 ± 0.08. All were significantly higher than those of the control group (0.46 ± 0.05,0.42 ± 0.09 and 0.52 ± 0.07;P<0.01). Conclusions The levels of AGE and RAGE in serum and placentas elevated in the severe preeclampsia group, and the expression of TNF-αalso elevated. These indicated that AGE and RAGE might be involved in the systemic inflammatory response and local inflammatory response in placentas, and then caused the preeclampsia.

OBJECTIVE: To observe the adverse effects of specific immunotherapy (SIT) with standardized dust mite allergen preparation in the treatment of allergic rhinitis. METHOD: Three hundred and eighty-six patients with allergic rhinitis who received subcutaneous SIT with a standardized dust mite allergen preparation were enrolled in this study. The patients were treated for at least 15 weeks,adverse effects after each injection from dosing phase to maintenance phase were recorded and incidence of adverse effects were analyzed. RESULT: Of all the patients,adverse reactions occurred in 42 patients (10. 9%),10 local reactions (2. 6%) and 36 systemic side effects (9. 3%) which included 34 mild ,1 moderate and 1 severe side effects (no fatal) were reported respectively. None had anaphylactic shock. Among three treatment options, incidence of routine program was the highest (21.1%),followed by adult cluster program (11. 9%), adverse effects of children cluster program was the least (1. 5%). The adverse effects often happened in the middle and late phase of does addition period and early phase of maintenance period. CONCLUSION SIT with standardized dust mite allergen preparation in the treatment of allergic rhinitis is a safe and effective treatment by complying with the guidelines and taking specific interventions.
Adult ; Animals ; Antigens, Dermatophagoides ; adverse effects ; therapeutic use ; Child ; Desensitization, Immunologic ; Humans ; Immunotherapy ; Pyroglyphidae ; Rhinitis, Allergic ; therapy ; Treatment Outcome

Objective To determine the distribution of allergens in patients with allergic rhinitis in Nanchang area and provide the clinical reference for management strategies with regional character.Methods Patients with symptoms of allergic rhinitis were given skin prick test (SPT) from March 2012 to May 2013.Among the patients,the distribution of all allergens was analyzed.The positive rate was compared with gender,age,occupation,season,course of disease and so on.SPSS 17.0 software was used to analyze the data.Results Among 5 654 patients,the total positive rate of SPT was 56.07％,with dermatophagoides pteronyssinus (46.94％),dermatophagoides farina (35.99％),blomia tropicalis (31.34％) as the major allergens.With age increasing,the positive rate of allergen decreased.There was statistically significant difference (x2 =261.372,P ＜ 0.01).There was significant difference of the positive rate in different occupations (x2 =170.859,P ＜0.01),the highest rate was found in student(66.12％) and the lowest was found in farmer (41.56％).There was significant difference of variation with months (x2 =227.333,P ＜ 0.01),the most in October,68.88％.There was significant difference of the positive rate of dust mites in different seasons (x2 =204.343,P ＜ 0.01),the highest in autumn,the lowest in winter.There was no correlation between the positive rate and course of disease (P ＞ 0.05).Conclusions Dust mites were identified as the most common allergens among patients with allergic rhinitis in Nanchang area.Occupation is one of the influeneing factors for the positive rate.

Objective To research the correlation of the expressions of lipocalin-2 (LCN-2) and its receptor (NGALR) in serum and placenta with preeclampsia.Methods From Dec.2010 to Apr.2011,64 women with preeclampsia who delivered in Affiliated Hospital of Qingdao University Medical College were recruited in the study,including 26 women with moderate preeclampsia ( MPE group) and 38 women with severe preeclampsia (SPE group).Twenty-five healthy pregnant women were taken as control group.LCN-2 and NGALR mRNA and protein expression in placenta were measured by reverse transcription-PCR ( RTPCR) and western blot,respectively.Results ( 1 ) The serum levels of LCN-2 in MPE group and SPE group [ (58 ±20),(90 ± 18) μg/L] were significantly higher than that in control group [ ( 19 ±6) μg/L,P＜0.01] ; the serum LCN-2 level in SPE group was significantly higher than that in MPE group (P ＜0.01).(2) LCN-2 mRNA expression in placenta in MPE group and SPE group (0.55 ±0.14,0.61 ±0.14) were both significantly higher than that in control group (0.28 ±0.16,P ＜0.01 ) ; LCN-2 protein expression in placenta of MPE group and SPE group ( 2.2 ± 0.4,2.4 ± 0.5 ) were also significantly higher than that in control group (1.4 ±0.4,P ＜0,01 ),no significant difference was found between MPE group and SPE group ( P ＞ 0.05 ),(3) No significant difference was found in the expressions of NGALR mRNA in placenta among MPE group,SPE group and control group (0.46 ±0.1l,0.46 ±0.14,0.45 ±0.15,P ＞0.05 ).(4) NGALR protein expressions in MPE group,SPE group and control group were 2.7 ±0.8,3.0 ±0.9,and 2.7 ± 0.9,and there were no significant difference among these three groups ( P ＞ 0.05 ).(5) In preeclampsia,serum LCN-2 level significant associated with 24 hours total urinary protein and uric acid ( r =0.565,0.476,P＜0.01).LCN-2 serum level were not associated with systolic pressure and diastolic pressure (P ＞ 0.05 ) ; there were no association with the expressions LCN-2 mRNA aud protein in placenta ( P ＞ 0.05).Conclusions Serum LCN-2 level is closely related to the progress of preeclampsia.Increasing expression of LCN-2 in placenta may be a compensatory response to preeclampsia.

Objective To assess the diagnostic predictive value of Wells score and modified Geneva score for acute pulmonary embolism by prospective case series and to explore a more suitable scoring system for Chinese population.Methods All the patients suspected of pulmonary embolism (PE) and received CT pulmonary angiography (CTPA) were enrolled consecutively in Fuxing Hospital,Capital Medical University,China,from June 2009 to August 2011.Before CTPA test or on condition that test results were unknown,clinical scoring was assessed prospectively by the Wells score and the modified Geneva score.The probability of PE in each patient was assessed and the patients were divided into low,moderate and high probability groups according to the clinical scores.The result of CTPA was used as the diagnostic gold standard for PE.Diagnostic accuracy in each group was analyzed.The predictive accuracy of both scores was compared by AUCROC curve.Results A total of 139 patients met our enrollment criteria and 117 eligible patients entered our study at last.PE was diagnosed in 47 patients by CTPA with an overall prevalence of 40.2％.Prevalence of PE in the low,moderate and high pretest probability groups assessed by the Wells score and by the simplified modified Geneva score were 7.1％ (3/42),42.9％ (21/49),88.5％ (23/26)and 10.0％ (3/30),48.1％ (37/77),7/10,respectively.AUCROC curves for the Wells score and the simplified modified Geneva score were 0.872 ( 95％ CI 0.810-0.933 ) and 0.734 ( 95％ CI 0.643-0.825 )respectively,with a significant difference ( P =0.005 ).Conclusion The Wells score is more accurate for clinical predicting acute PE than the modified Geneva score.