OBJECTIVE To investigate the clinical characteristics of glucocorticoid allergy， and provide treatment and prevention strategies for patients with concurrent bronchial asthma. METHODS A retrospective analysis was conducted on the clinical data of 250 patients with suspected glucocorticoid allergy admitted to the First Affiliated Hospital of Army Medical University （hereinafter referred to as “our hospital”）from May 1st， 2002， to April 30th， 2022； and a typical case analysis was carried out. RESULTS Among 250 patients with suspected glucocorticoid allergy， 140 were female patients （56.00%） and 110 were male patients （44.00%）. The majority of admissions were to the internal medicine department （118 cases， 47.20%）. One hundred and seventy patients （68.00%） were allergic to dexamethasone， and 37 patients （14.80%） were allergic to prednisone. Two hundred and thirty-eight patients （95.20%） were allergic to one type of glucocorticoid， and 12 patients （4.80%） were allergic to two types of glucocorticoid. Ten patients had clear records of glucocorticoid administration routes， in which 6 were intravenous and 4 were oral. Among the 250 patients， only 32 cases had clear records of clinical manifestations of glucocorticoid allergy， the most common clinical manifestations were rash （12 cases） and skin itching （8 cases）， with 6 patients experiencing both rash and skin itching. The treatment for glucocorticoid allergy mainly involved discontinuing the medication and providing symptomatic treatment. For patients with concurrent bronchial asthma， it was generally necessary to switch to other glucocorticoids in their subsequent treatment to control the condition. The incidence of suspected glucocorticoid allergy among inpatients in our hospital during the same period was 0.019%. The incidence of suspected glucocorticoid allergy with concurrent bronchial asthma was 0.201%. Additionally， a case analysis of bronchial asthma combined with chronic obstructive pulmonary disease in our hospital resulted in glucocorticoid allergy revealed that， based on the patient’s medical history and drug challenge test results， the patient was diagnosed with glucocorticoid （Methylprednisolone tablets and Dexamethasone acetate tablets） allergy， and antihistamine treatment was effective. CONCLUSIONS Glucocorticoid allergy is clinically rare， and its clinical manifestations are predominantly mild reactions such as rashes and skin itching. For patients with concurrent bronchial asthma who experience glucocorticoid allergy， treatment options include switching to other glucocorticoids， altering the route of glucocorticoid administration， symptomatic treatment， and the use of immunosuppressive agents as adjunctive or alternative therapy.

'Zhizhang Guhong Chongcui' is a new cultivar of Prunus mume with cross-cultivar group characteristics. It has typical characteristics of cinnabar purple cultivar group and green calyx cultivar group. It has green calyx, white flower, and light purple xylem, but the mechanism remains unclear. In order to clarify the causes of its cross-cultivar group traits, the color phenotype, anthocyanin content and the expression levels of genes related to anthocyanin synthesis pathway of 'Zhizhang Guhong Chongcui', 'Yuxi Zhusha' and 'Yuxi Bian Lü'e' were determined. It was found that the red degree of petals, sepals and fresh xylem in branches was positively correlated with the total anthocyanin content. MYBɑ1, MYB1, and bHLH3 were the key transcription factor genes that affected the redness of the three cultivars of flowers and xylem. The transcription factors further promoted the high expression of structural genes F3'H, DFR, ANS and UFGT, thereby promoting the production of red traits. Combined with phenotype, anthocyanin content and qRT-PCR results, it was speculated that the white color of petals of 'Zhizhang Guhong Chongcui' were derived from the high expression of FLS, F3'5'H, LAR and ANR genes in other branches of cyanidin synthesis pathway, and the low expression of GST gene. The green color of sepals might be originated from the relatively low expression of F3'H, DFR and ANS genes. The red color of xylem might be derived from the high expression of ANS and UFGT genes. This study made a preliminary explanation for the characteristics of the cross-cultivar group of 'Zhizhang Guhong Chongcui', and provided a reference for molecular breeding of flower color and xylem color of Prunus mume.
Animals ; Anthocyanins ; DNA Shuffling ; Flowers/genetics* ; Porifera ; Prunus/genetics* ; Glutamine/analogs & derivatives* ; Plant Extracts

Diabetic kidney disease (DKD) is the most common complication of diabetes mellitus (DM). Qianjin Wenwu decoction (QWD), a well-known traditional Korean medicine, has been used for the treatment of DKD, with satisfactory therapeutic effects. This study was designed to investigate the active components and mechanisms of action of QWD in the treatment of DKD. The results demonstrated that a total of 13 active components in five types were found in QWD, including flavonoids, flavonoid glycosides, phenylpropionic acids, saponins, coumarins, and lignins. Two key proteins, TGF-β1 and TIMP-1, were identified as the target proteins through molecular docking. Furthermore, QWD significantly suppressed Scr and BUN levels which increased after unilateral ureteral obstruction (UUO). Hematoxylin & eosin (H&E) and Masson staining results demonstrated that QWD significantly alleviated renal interstitial fibrosis in UUO mice. We also found that QWD promoted ECM degradation by regulating MMP-9/TIMP-1 homeostasis to improve renal tubulointerstitial fibrosis and interfere with the expression and activity of TGF- β1 in DKD treatment. These findings explain the underlying mechanism of QWD for the treatment of DKD, and also provide methodological reference for investigating the mechanism of traditional medicine in the treatment of DKD.
Rats ; Mice ; Animals ; Ureteral Obstruction/metabolism* ; Kidney/metabolism* ; Tissue Inhibitor of Metalloproteinase-1/metabolism* ; Molecular Docking Simulation ; Rats, Sprague-Dawley ; Kidney Diseases/drug therapy* ; Extracellular Matrix/metabolism* ; Flavonoids/metabolism* ; Fibrosis

For cochlear implant training and robotic cochlear implant experiments, the design method of scalable scala tympani model was proposed. The mathematical model of the cochlea was used as the central curve of scala tympani channel. Referring to the clinical anatomy data, the contour of the scala tympani cross-section was approximated as an ellipse. The profile was placed along the central curve, and the angle was adjusted to determine the position and orientation of the profile in three dimensions such that the central curve passes through its center. The data was imported into Matlab to generate a three-dimensional mathematical model of scala tympani, which can be expanded by setting different scale factors. The virtual scala tympani model was generated in SolidWorks, and the 2:1 fully transparent scala tympani model were fabricated by 3D printing to replace the specimen for experiment.
Cochlea/surgery* ; Cochlear Implantation ; Cochlear Implants ; Robotics ; Scala Tympani/surgery*

Objective:To explore the difference of high-risk factors between early-onset and late-onset pre-eclampsia, and to further understand high-risk factors of pre-eclampsia.Methods:Clinical data of pre-eclampsia pregnant women in 160 medical institutions in China in 2018 were retrospectively analyzed, including 8 031 cases of early-onset pre-eclampsia and 12 969 cases of late-onset pre-eclampsia. The proportion of high-risk factors, different body mass index (BMI) and age stratification between early-onset group and late-onset group were compared.Results:(1) Univariate analysis of high-risk factors: the proportions of high-risk factors in early-onset group and late-onset group were compared, and the differences were statistically significant (all P<0.05). Among them, the proportions of primipara and multiple pregnancy in early-onset group were lower than those in late-onset group, while the proportions of pregnant women with advanced age, irregular antenatal examination, obesity, family history of hypertension, pre-eclampsia, diabetes, kidney diseases, immune system diseases and assisted reproductive technology were higher than those in late-onset group. (2) Hierarchical analysis of BMI: the proportion of pregnant women with BMI≥24 kg/m 2 in early-onset group [48.2% (2 828/5 872) vs 45.5% (4 177/9 181), respectively; P=0.001] and the proportion of pregnant women with BMI ≥28 kg/m 2 in early-onset group [19.5% (1 143/5 872) vs 18.0% (1 656/9 181), respectively; P=0.028] were significantly higher than those in late-onset group. (3) Age stratification analysis: the proportion of pregnant women aged 35-39 years in the early-onset group [21.8% (1 748/8 023) vs 17.5% (2 110/12 068), respectively; P<0.01], the proportion of pregnant women 40-44 years old [6.8% (544/8 023) vs 5.4% (648/12 068), respectively; P<0.01], and the proportion of pregnant women ≥45 years old [0.7% (58/8 023) vs 0.5% (57/12 068), respectively; P=0.021] were significantly higher than those in the late-onset group. (4) Multivariate analysis: advanced age (≥35 years old), multiple pregnancy, irregular antenatal examination or transfer from other hospitals, family history of hypertension (including paternal, maternal and parental lines), previous history of pre-eclampsia, kidney diseases, immune system diseases (systemic lupus erythematosus, antiphospholipid antibody syndrome) and assisted reproductive technology pregnancy were the risk factors affecting the severity of pre-eclampsia (all P<0.05). Conclusion:Pregnant women with high risk factors such as age ≥35 years old, BMI ≥24 kg/m 2 before pregnancy, family history of hypertension, history of pre-eclampsia, chronic kidney diseases, immune diseases (mainly including systemic lupus erythematosus and antiphospholipid syndrome) and assisted reproductive technology are more likely to have early-onset pre-eclampsia.

Objective To explore hemodynamic performance of the aortic dissection after lesions, so as to provide a more scientific basis for patient treatment. Methods Based on computed tomography angiography (CTA) image data from a patient with complex Stanford B-type aortic dissection, the personalized aortic dissection models with different rupture shapes (H-type, O-type, and V-type) at proximal end of the aortic dissection were established. Combined with computational fluid dynamics (CFD) and morphological analysis method, distributions of the velocity at rupture section, the blood flow, the wall pressure and the wall shear stress (WSS) were analyzed. Results The flow velocity, the highest pressure difference and the WSS proportion at entrance of the H-shaped rupture showed larger hemodynamic parameters than those of the other two types. The risk of dissection rupture for type H was the largest, while type V was in the middle, and type O was the smallest. Conclusions This study provides an effective reference for further numerical analysis the cases and formulation of treatment plans.

Objective:To understand the output of research and education of clinical key Specialties in Henan Province, to analyze the current situation and existing problems, and to provide scientific evidence and suggestions for the improvement of specialist ability.Methods:Through the questionnaire survey to collect the scientific research data of key specialties from 2015 to 2019, apply Epidata 3.0 to input the data, use SPSS 21.0 software to carry out test and Mann Whitney U test, and carry out a comparative analysis of the national and provincial clinical key specialty discipline leaders, medical talent team, academic, scientific research and education output in Henan Province. Results:Academic literacy and scientific research ability of leaders of national and provincial key clinical specialties in Henan Province are equal. However, there is still a big gap in scientific research and education ability between national and provincial key clinical specialties in Henan Province.Conclusions:The provincial key clinical specialties need to improve the ability of scientific research and education in a more holistic way, further strengthen the medical talents team, and focus on the exchange of high-level academic platform and the cultivation of research talents.

Objective:To evaluate the comprehensive strength of the specialties included in the medical service capacity improvement project of Henan provincial medical and health institutions, analyze the influencing factors, and provide scientific basis for the specialty construction.Methods:A total of 52 specialties were included in the project. According to the content of construction assessment and acceptance, the questionnaire was designed and filled in by the persons in charge of the specialties from the aspects of basic conditions, medical technical team, medical service ability, medical quality, scientific research and teaching ability. TOPSIS method was used to evaluate the comprehensive strength of specialty, and the main influencing factors were analyzed by single factor analysis, Mann-Whitney U test, correlation analysis and multiple stepwise regression analysis. Results:The research and teaching ability of the specialties had the strongest correlation with the comprehensive strength of the specialties. The scientific research and teaching ability was strongly related to the medical service ability. The number of people holding the post of academic institutes at or above provincial level, the number of industry standards or national guidelines, the number of academic conferences hosted at or above the provincial level, the number of postgraduate training, the number of papers published in SCI and core journals were the main influencing factors of scientific research and teaching ability.Conclusions:It is necessary to improve the level of scientific research and teaching in key specialty to promote the improvement of medical service ability. We should pay more attention to the construction of high-level talents, the cultivation of research-oriented talents, the application of new medical technology and original research.

Objective:To investigate the epidemiological characteristics and current status of surgical management for esophageal cancer in China.Methods:A national database was setup through a network platform. The clinical data of esophageal cancer treated by surgery was collected from 70 major hospitals in China between January 2009 and December 2014.Results:Complete data of 8 181 cases of esophageal cancer patients who underwent surgery were recorded in the database and recruited in the analysis. Among them, 6 052 cases were male and 2 129 were female, the average age was 60.5 years.The epidemiological investigation results showed that 148 cases (1.8%) had history of psychological trauma, 7 527 cases (92.0%) were lower social economic status, 5 072 cases (62.0%) were short of fresh vegetables and fruits, 6 544 cases (80.0%) ate rough food frequently, 3 722 cases (45.5%) drank untreated water directly from lake or river or shallow well, 3 436 cases (42.0%) had a unhealthy eating habit, including habits of eating food fast (507 cases, 6.2%), eating hot food or drinking hot tea/soup (998 cases, 12.2%), eating fried food (1 939 cases, 23.7%), 4 410 cases (53.9%) had the habits of smoking cigarettes and 2 822 cases (34.5%) drank white wine frequently.The pathological results showed that 7 813 cases (95.5%) were squamous cell carcinoma, 267 cases were adenocarcinoma (3.3%), 25 cases were adenosquamous cell carcinoma (0.3%) and 50 cases were small cell carcinoma (0.6%). A total of 1 800 cases (22.0%) received preoperative neoadjuvant therapy due to locally advanced disease or difficulty of resection. The esophagectomies were performed through left thoracotomy approach in 5 870 cases (71.8%), through right chest approach in 2 215 cases (27.1%), and the remain 96 cases (1.2%) received surgery though other approaches.A total of 8 001 cases (97.8%) underwent radical resection, the other 180 cases (2.2%) received palliative resection. The 30-day postoperative mortality rate was 0.5%, the overall ≥ grade Ⅱ postoperative complication rate was 11.6% (951 cases). The 1-yr, 3-yr, and 5-yr overall actual survival rates were 82.6%, 61.6%, and 52.9%, respectively.Conclusions:The data analysis of the national database for esophageal cancer shows that bad eating habits or eating rough food without enough nutrients, lower social and economic status, drinking white wine and smoking cigarettes frequently may be correlated with tumorigenesis of esophageal cancer. However, strong evidences produced by prospective observation studies are needed. Overall, the long-term survival of esophageal cancer patients has been improved gradually due to the application of advanced surgical techniques and reasonable multimodality treatment.

Objective:To investigate the epidemiological characteristics and current status of surgical management for esophageal cancer in China.Methods:A national database was setup through a network platform. The clinical data of esophageal cancer treated by surgery was collected from 70 major hospitals in China between January 2009 and December 2014.Results:Complete data of 8 181 cases of esophageal cancer patients who underwent surgery were recorded in the database and recruited in the analysis. Among them, 6 052 cases were male and 2 129 were female, the average age was 60.5 years.The epidemiological investigation results showed that 148 cases (1.8%) had history of psychological trauma, 7 527 cases (92.0%) were lower social economic status, 5 072 cases (62.0%) were short of fresh vegetables and fruits, 6 544 cases (80.0%) ate rough food frequently, 3 722 cases (45.5%) drank untreated water directly from lake or river or shallow well, 3 436 cases (42.0%) had a unhealthy eating habit, including habits of eating food fast (507 cases, 6.2%), eating hot food or drinking hot tea/soup (998 cases, 12.2%), eating fried food (1 939 cases, 23.7%), 4 410 cases (53.9%) had the habits of smoking cigarettes and 2 822 cases (34.5%) drank white wine frequently.The pathological results showed that 7 813 cases (95.5%) were squamous cell carcinoma, 267 cases were adenocarcinoma (3.3%), 25 cases were adenosquamous cell carcinoma (0.3%) and 50 cases were small cell carcinoma (0.6%). A total of 1 800 cases (22.0%) received preoperative neoadjuvant therapy due to locally advanced disease or difficulty of resection. The esophagectomies were performed through left thoracotomy approach in 5 870 cases (71.8%), through right chest approach in 2 215 cases (27.1%), and the remain 96 cases (1.2%) received surgery though other approaches.A total of 8 001 cases (97.8%) underwent radical resection, the other 180 cases (2.2%) received palliative resection. The 30-day postoperative mortality rate was 0.5%, the overall ≥ grade Ⅱ postoperative complication rate was 11.6% (951 cases). The 1-yr, 3-yr, and 5-yr overall actual survival rates were 82.6%, 61.6%, and 52.9%, respectively.Conclusions:The data analysis of the national database for esophageal cancer shows that bad eating habits or eating rough food without enough nutrients, lower social and economic status, drinking white wine and smoking cigarettes frequently may be correlated with tumorigenesis of esophageal cancer. However, strong evidences produced by prospective observation studies are needed. Overall, the long-term survival of esophageal cancer patients has been improved gradually due to the application of advanced surgical techniques and reasonable multimodality treatment.