Objective To investigate the distribution characteristics of inhalant and ingestive allergens in patients with allergic rhinitis(AR)in Lishui area,and then provide evidences for the clinical diagnosis,treatment and prevention of AR.Methods The detection data of serum sIgE antibodies to allergens from 1 610 patients with suspected AR visited the Department of Otolaryngology of Lishui Central Hospital during January 2020 and December 2022 were collected,and the distribution characteristics of various allergen spectra in AR patients were further analyzed.Results A total of 1 020 patients were diagnosed with AR and the positive rate of serum sIgE an-tibodies to allergens was 63.35%.The positive rate(66.59%)in male AR patients was significantly higher than that in females(59.48%,P＜0.01).The main allergen among AR patients in Lishui area was house dust mite.The top five inhalant allergens were house dust mite(77.94%),mixed mold(10.20%),cat dander(9.22%),tree pollen(5.88%),and dog dander(3.43%).The top five ingestive allergens were milk(23.33%),crab(7.75%),cashew nut(6.67%),shrimp(4.41%),and egg protein(3.33%).The positive rates of serum sIgE antibodies to milk,crab,and shrimp in males were significantly higher than that in females(P＜0.05).There were significant differences in the positive rates of serum sIgE antibodies to house dust mite,mulberry tree,cockroach,tree pol-len,and grass pollen among different age groups(P＜0.05).The positive rates of serum sIgE antibodies to egg protein,milk,crab,and amaranth were significantly different(P＜0.05).There were seasonal differences in the positive rates of serum sIgE antibodies to house dust mite,mulberry,mixed mold,tree pollen,and grass pollen(P＜0.05).Conclusion The allergens of AR patients in Lishui area are diverse and complex,and are affected by factors such as gender,age and season.

Objective To investigate the effect of intravenous lidocaine on enhanced recovery of elderly men after laparoscopic radical prostatectomy.Methods A total of 78 patients who planned to undergo laparoscopic radical prostatectomy in Affiliated Lihuili Hospital of Ningbo University from September to December 2023 were selected as study objects,and they were divided into control group and experimental group according to random number table method,with 39 patients in each group.Experimental group received intravenous lidocaine of 1.5mg/kg during induction of anesthesia,followed by micropump injection at a rate of 2mg/(kg·h),and control group was injected with an equal amount of normal saline.The intraoperative dosage of propofol and remifentanil was recorded.Visual analogue scale(VAS)score,postoperative postanesthesia care unit(PACU)residence time,first anal exhaust time,first defecation time,first getting out of bed activity time,length of hospital stay,number of effective patient-controlled intravenous analgesia(PCIA)compressions within 48h after surgery,number and dosage of sufentanil addition,quality of recovery-40(QoR-40)scale score,and occurrence of adverse reactions within 48h after surgery were compared between two groups.Results The intraoperative dosage of propofol and remifentanil,the number of effective PCIA compression,the number of sufentanil addition and the amount of sufentanil in postoperative 48h in experimental group were significantly lower than those in control group(P＜0.05).The VAS scores of experimental group at 2h,6h,12h,24h and 48h were significantly lower than those of control group(P＜0.05).The PACU residence time,first anal exhaust time,first defecation time,first getting out of bed activity time and hospital stay time of experimental group were significantly shorter than those of control group(P＜0.05).The incidence of nausea and vomiting in experimental group was significantly lower than that in control group within postoperative 48h(P＜0.05),and no adverse reactions such as drowsiness,respiratory depression,and severe bradycardia occurred in both groups.48h after surgery,the comfort,emotion,pain scores and total scores of QoR-40 in experimental group were significantly higher than those in control group(P＜0.05).Conclusion In elderly men undergoing laparoscopic radical prostatectomy,intravenous infusion of lidocaine can reduce the amount of perioperative anesthetic drugs,reduce postoperative pain and adverse reactions,and promote postoperative recovery.

Objective:To analyze and compare the practical value of serum cystatin C(Scys C)and serum creatinine(SCr)in the assessment of kidney function in older adults.Methods:A retrospective, cross-sectional study was performed in 2 450 participants who were divided into a non-elderly group(<65 years)and an elderly group(≥65 years).Glomerular filtration rate(GFR), Scys C and SCr were measured by 99mTc-DTPA clearance, particle-enhanced immunoturbidimetry and an oxidase method, respectively.The χ2 test was used to compare increases in percentage of Scys C and SCr at the same GFR level.The screening value of Scys C and SCr for GFR<60 ml·min -1·1.73m -2was evaluated by the area under curve(AUC)of the receiver operating characteristic(ROC)curve.Values of 95% reference ranges were established for Scys C and SCr at different GFR levels. Results:The proportions of the general population with increased Scys C were 82.74%(556/672)and 94.74%(90/95), respectively, for GFR levels between 30~59 ml·min -1·1.73m -2and <30 ml·min -1·1.73m -2, while only 38.24%(257/672)and 75.79%(72/95)had elevated SCr levels( χ2=278.328, 13.571, both P<0.001).For the above GFR intervals, the proportions of older adults with increased Scys C were 84.81%(240/283)and 100.00%(43/43)respectively, and the proportions for non-elderly adults with increased Scys C were 81.23%(316/389)and 90.38%(47/52)( χ2=1.463, 4.364, P=0.226, 0.037), respectively.The screening value of Scys C for GFR<60 ml·min -1·1.73m -2was slightly better than SCr in terms of sensitivity, specificity and the Youden index.However, the sensitivity and specificity of Scys C in older adults were 76.4% and 75.7%, respectively, both lower than 78.7% and 84.0% in non-older adults.The variability of Scys C increased progressively with age.The reference range for Scys C was higher in older adults than in non-older adults at the same GFR level. Conclusions:When screening for GFR<60 ml·min -1·1.73m -2, the sensitivity and specificity of Scys C are slightly better than those of SCr, but are lower in older adults than in non-older adults.Scys C levels are higher and more variable in older adults.Using Scys C to assess GFR may lead to over-diagnosis of chronic kidney disease in older adults.

Objective:To investigate the function of the expression rate of vitamin D, T helper cell 17 (Th17) and regulatory T cells (Tregs) and the serum level of tumor necrosis factor-α (TNF-α) and monocyte chemotactic protein-1 (MCP-1) in the pathogenesis of adolescents with multiple sclerosis (MS).Methods:Thirty-eight adolescent patients diagnosed with MS in the Department of Pediatrics of the First Affiliated Hospital of Xinxiang Medical University from January 2010 to December 2020 were selected as the MS group, and 38 healthy adolescents matched with age and body mass index were selected as healthy control group.The level of 25-hydroxyvitamin D 3 [25-(OH)D 3] was measured by liquid chromatograph; the expression rates of Th17 and Tregs were measured by flow cytometry; the serum levels of TNF-α and MCP-1 were measured by immunofluorescence.SPSS 22.0 statistical software was adopted to analyze the differences between the above indicators and their correlation in the MS group and the healthy control group. Results:There was no difference in the level of 25-(OH)D 3 in peripheral blood between the MS group and the healthy control group( P>0.05). As for the MS group, the expression rate of Th17 was significantly higher than that in the healthy control group [(3.02±0.20)% vs.(1.99±0.16)%, t=12.03, P<0.05]; the expression rate of Tregs in peripheral blood was significantly lower than that in the healthy control group [(4.63±0.77)% vs.(5.10±0.90)%, t=14.65, P<0.05]; the ratio of Th17 to Tregs was significantly higher than that in the healthy control group (0.25±0.07 vs.0.17±0.05, t=16.89, P<0.05); the levels of TNF-α and MCP-1 in peripheral blood were higher than those in the healthy control group [(26.13±5.98) ng/L vs.(24.45±3.01) ng/L; (122.26±37.71) ng/L vs.(87.95±17.66) ng/L, t=1.986, 47.650, all P<0.05]. In the MS group, 25-(OH)D 3 in peripheral blood was not correlated with other test indicators; the levels of TNF-α and MCP-1 were higher in patients with relapsing or progressive disease than in patients with stable disease in remission [(17.49±3.94) ng/L vs.(14.45±3.81) ng/L; (90.42±23.06) ng/L vs.(77.55± 20.56) ng/L, t=1.990, 2.472, all P<0.05]; the expression rate of Th17 cells was positively correlated with the level of TNF-α and MCP-1 in peripheral blood ( r=0.478, 0.442, all P<0.05); the expression rate of Tregs was negatively correlated with the level of TNF-α and MCP-1 in peripheral blood ( r=-0.318, -0.356, all P<0.05). Conclusions:Th17 and Tregs may be involved in the immunopathological mechanisms in the pathogenesis of adolescents with MS; changes in associated cytokines may be involved in the regulation of Th17 and Tregs changes and the inflammatory response; Th17 and Tregs and associated cytokine changes may play an important role in the occurrence, progression, and relapse progression of MS as an immunopathological mechanism.

Objective To investigate the effect of Santong electroacupuncture (EA) on mRNA and protein expression of p75 neurotroph-in receptor (p75NTR) in rats with spinal cord injury (SCI). Methods A total of 72 female Sprague-Dawley rats were randomly assigned to sham operation group (group A, n=8) and model group (n=64). In the model group, Allen's method was used to make SCI rats model, in which 48 survived model rats were further subdivided into model control group (group B, n=12), EA group (group C, n=12), inhibitor Nogo extra cellular peptide residues 1-40 (NEP1-40) group (group D, n=12) and EA+inhibitor NEP1-40 group (group E, n=12) according to de-sign proposal. The treatment groups were electroacupunctured on Dazhui (GV14) and Yaoyangguan (GV3), bilateral Ciliao (BL32) and Zu-sanli (ST36) with loose-tight wave, for 20 minutes every day. After 7 and 14 days of treatment, injured spinal cord tissue was extracted for detecting. The mRNA and protein expression of p75NTR was detected by real-time fluorescent quantitative PCR, in situ hybridization and Western blotting respectively. The hind limb motor function was assessed with Basso-Beattie-Bresnahan (BBB) score. Results The BBB score increased in the treatment groups compared with group B, and was higher in group E than in groups C and D (P<0.05), as well as on the 14th day than on the 7th day in all the treatment groups (t>2.623, P<0.05). The mRNA and protein expression of p75NTR in spinal cord tissues decreased in the treatment groups compared with group B (P<0.05), and no significant difference was found among the treatment groups (P>0.05). Conclusion Santong elerctroacupuncture treatment could improve the hind limb motor function, which may associate with inhibition of the mRNA and protein expression of p75NTR in rats after SCI.

Objective: To analyze the clinical characteristics of community-acquired pneumonia (CAP) in children under five years of age and analyze the safety and efficiency of nasal continuous positive airway pressure (NCPAP) ventilation for CAP in this population. Method: This was a prospective multicenter study. Children who were admitted to these six centers with CAP and met the NCPAP ventilation indications, aged from 29 d to 5 years, were continuously included during November 2013 to October 2015. The baseline data were collected and NCPAP ventilation were then followed up by operation standards, and the vital signs and arterial blood gas change at special time points were observed and recorded. Any side effect associated with NCPAP were recorded. For categorical variables, comparisons were performed using Fisher test. Rank-sum test and t test were performed respectively for abnormal and normal distribution continuous variables. The variables pre-NCPAP and post-NCPAP were analyzed by repeated measures ANOVA analysis. Result: Totally 145 children were included, and 13 children were excluded due to incomplete data. One hundred and two children(77.3%)were ≤12 months; 91 children (68.9%) were from rural area. NCPAP ventilation was effective in 123 children, with a response rate of 93.2%, were all discharged with a better condition; it was ineffective in 9 children(6.8%), and they were all intubated and went on mechanical ventilation, 5 were discharged with a better condition, and 4 died after gaving up treatment. The gender, age, body weight, residence, main symptoms, main signs, imaging diagnosis, medications, partial pressure of oxygen(PaO₂), breath and heart rate before NCPAP treatment of two groups had no significant differences(allP>0.05). The rates of combining underlying diseases, trouble with feeding and cyanosis, and the partial pressure of carbon dioxide(PaCO₂ ) before NCPAP ventilation were higher in NCPAP ineffective group ((59±11 )vs.( 49±11) mmHg, 1 mmHg=0.133 kPa, t=-2.597, P=0.028); while the PaO₂/fraction of inspiration O₂ (FiO₂ ) before NCPAP was lower((150±37) vs. (207±63) mmHg, t=2.697, P=0.008). The breathing, heart rate and PaCO₂ of NCPAP effective group decreased significantly, while the PaO₂ and PaO₂/FiO₂ increased significantly after 2, 8, 24 h of NCPAP ventilation(all P=0.000). PaCO₂ in children with hypercapnia before NCPAP ventilation in NCPAP effective group decreased significantly ((48±9), (47±12), (45±11)vs.(58±7)mmHg, all P=0.000). All children tolerated well to NCPAP ventilation, and there were no severe side effects or complications associated with NCPAP ventilation. Conclusion NCPAP ventilation is safe and effectively improved the oxygenation and hypercapnia in infants with CAP. But it may not work well in children with underlying diseases, manifest as difficulty in feeding/cyanosis and extremely high PaCO₂ or low PaO₂/FiO₂, and they may need early intubation.

[ABSTRACT]OBJECTIVETo study the mRNA expression of glucocorticoid receptor(GR) in peripheral blood mononuclear cells in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) and its clinical significance. METHODSReal-time fluorescent quantitative PCR was used to detect GRα mRNA and GRβ mRNA exprssion in PBMC of 30 male patients with moderate to severe OSAHS and 27 healthy male subjects. The relationships between the expression of glucocorticoid receptor mRNA and the apnea hypopnea index, body mass index, neck circumference, waist circumference, the lowest oxygen saturation, the average oxygen saturation, the Epworth sleepiness scale(ESS) score, fasting blood glucose, heart rate and blood pressure were analyzed.RESULTSCompared with the control group, the expression level of GRα mRNA was lower in the OSAHS group(t=2.25,P<0.05) and the expression level of GRβmRNA had no difference between the two groups(t=1.43, P>0.05). We had not found the significant correlation between the expression of GRα mRNA and the clinical parameters above in OSAHS patients.CONCLUSIONThe expression of GRα mRNA in PBMC in moderate to severe OSAHS male patients have a downward trend compared with healthy group, but the mechanism remains unclear.

Objective To investigate the effects of lipopolysaccharide(LPS) on the tryptophan-kynurenine(TRP) metabolic pathway in rat brains and provide new evidence for the relationship between inflammation and depression.Methods Rats in LPS group were given a single dose of 3.5 mg/kg LPS.while the rats in control group were given the same dosage of saline.The dialysis in ventro-hippocampus were collected by microdialysis within 8 hours and then the TRP,KYN and KA were detected by LC-MS/MS.And the expression of indoleamine 2,3-dioxygenase was detected by Western-blot.Results The level of TRP((550.15± 107.96) pmol/L) and KYN ((337.95±62.73) pmol/L) showed a time-dependent increase after administration LPS 4 h compared with the control group(TRP (368.38±59.31) pmol/L,KYN (172.80±43.96) pmol/L),while KA level in the circulation exhibited a trend to decrease,especially at 7 h ((3.47±0.62) pmol/L,P＜0.05).The ratio of KYN/TRP significantly increased at about 5 h (0.69±0.11,P＜ 0.05),and an ratio of KA/KYN (0.02±0.00) was dramatically decreased after administering LPS 4 h compared with the control group (0.05±0.01)(P＜0.05).Most of the analytes showed more dramatic changes around 4 h to 8 h.LPS group(1.48±0.37) increased the protein expression of indoleamine 2,3-dioxygenase compared with the control group(1.00±0.24) (P＜0.01).Conclusions LPS may cause tryptophan metabolic abnormalities and accelerate the way of kynurenine metabolism,leading to decreased the kynurenic acid status.

Objective To study the non-fermenter isolation rate and its drug resistance to more than 10 kinds of antibiotics at the First Affiliated Hospital to Xinxiang Medical University from the year of 2010 to 2012 in order to offer evidences for reasonable use of drugs by doctors and to prevent nonfermenters from becoming common pathogenic bacteria.Methods The infection and drug resistance of different Nonfermenters (Pseudomonas aeruginosa,Acinetobacter baumannii,Pseudomon as mahophilia,Los non Acinetobacter,Pseudomonas stutzeri,Achromobacter,Bacillus steady short,onions Bock cepacia,meningitis septicemia Elizabeth Kim bacteria)during present 3 years were analyzed by using WHONET 5.5 software.Results The infection rate from non-fermenters as pathogenic bacteria was gradually increased,with the rate from 18.2％ to 27.2％,until 31.2％ ; Acinetobacter Baumannii were isolated as higher infection rate and multiple drug resistance (7.1％ to 18.5％ until 28.7％) in pathogenic bacteria; the infection rate of other non-fermenter with infection rate of high and multiple drug resistance in pathogenic bacteria were gradually increased,such as infection rate or the precedence of Achromobacter xylosoxidans and Pseudomonas maltophilia,especially the precedence of Pseudomonas maltophilia ranged the third in non-fermenters,and Pseudomonas maltophiliai had a higher and multiple drug resistance to many antibiotics; infection rate of non-fermenters with low drug resistance gradually decreased,such as Pseudomonas fluorescens; the drug resistance rate of Acinetobacter Baumannii was higher than that of Pseudomonas aeruginosa and its drug resistance rate was over 50％ to common antibiotics used clinically,as well as Pseudomonas maltophiliai and Empedobacter brevis,especially the resistance rate of Pseudomonas maltophiliai to many commonly used antibiotics was more than 90.0％.Conclusions Non-fermenter isolation rate is becoming higher clinically and its drug resistance becomes more severe,so the sanitation administration department should pay more attention to the use of antibiotics in order to prevent and control drug resistance and higher infection rate caused by non-fermenters as a serious consequence.

ts the shear stress, thus, facilitates the union of fracture and the restoration of function.