Objective:To analyze the distribution, prevalence, clinical characteristics, risk factors, treatment, prevention and control of Artemisia pollen-induced allergic rhinitis（PiAR） in Hohhot, Inner Mongolia, northern China. Methods:From April to June 2023, a multi-stage, stratified and random sampling method was used to conduct a full coverage epidemiological investigation in the 4 districts and 5 counties of Hohhot City. Face-to-face questionnaire surveys and skin prick tests（SPT） were conducted on the population, while pollen counts were used to monitor pollen exposure levels, to observe the prevalence, population distribution characteristics, major risk factors and control of Artemisia pollen PiAR. Data processing was carried out using SAS software 9.4. Results:A total of 1 621 patients allergic to Artemisia pollen completed the questionnaire, with a prevalence rate of 26.7%. The high-incidence age group was 13-17 years old, and the prevalence rate in urban areas was higher than that in rural areas. The main clinical symptoms are mainly nasal itching, sneezing and clear nasal discharge. The pollen amount of Artemisia reaches its peak in September. The peak time of the frequency of clinical symptoms in patients with Artemisia PiAR is about one month earlier than the peak time of pollen concentration. Under the comprehensive prevention and control strategy, compared with 2020, the application of antihistamines and nasal spray hormones has increased, and the degree of symptom reduction, the proportion of preventive medication in advance during the pollen season, and the proportion of regular medication during the pollen season have also increased（P<0.01）. Conclusion:This study clarified the prevalence rate, risk factors and prevention and control of PiAR in Artemisia pollen. It provides rich data and basis for in-depth research and prevention and control of this disease.

Heart failure (HF) with supranormal ejection fraction (HFsnEF, LVEF ≥ 65%) is a newly defined subtype of HF. Its pathophysiological complexity and lack of effective animal models have hindered its treatment research progress. The aim of this study is to explore the characteristics of the HFsnEF mouse model induced by an adenine diet and elucidate the cardioprotective effect of pregnane X receptor (PXR) agonist and its molecular mechanism. C57BL/6J mice were fed with a 0.2% adenine diet for 28 days to establish HFsnEF model. Cardiac function parameters (left ventricular ejection fraction, cardiac output, interventricular septal thickness, left ventricular volume, and left ventricular diameter) were evaluated by small animal ultrasound (Vevo 3100), and the degree of myocardial injury and fibrosis were analyzed by histopathology. Tunel staining was used to detect the level of apoptosis. Immunofluorescence, RT-PCR, and western blot were used to detect the expression of myocardial cell apoptosis markers (p53, Bax, Bcl2, Caspase3, and cleave-Caspase3), cardiac capillary density marker (CD31), and cardiomyocyte hypertrophy-related markers (ANP and β-MHC). In vitro, the adenine was used to simulate the injury model of H9c2 cardiomyocytes. CCK-8 was used to detect cell viability. Adenine diet successfully induced the phenotype of HFsnEF in mice, which was characterized by smaller hearts, significantly increased ejection fraction (≥ 65%), reduced cardiac output, specific ventricular posterior wall thickening during systole, impaired diastolic function, ventricular shrinkage, myocardial fibrosis and hypertrophy, and decreased blood pressure and heart rate. Mechanistically, the Tunel staining and the expression of p53, Bax, cleave-Caspase3/Caspase3, and Bcl2 indicated that adenine induced cardiomyocyte apoptosis. However, these adenine-induced changes were reversed by PXR agonists. This is the first study to establish an HFsnEF mouse model induced by an adenine diet, and reveals that PXR agonists can alleviate myocardial injury by regulating the p53-Bax/Bcl2 apoptosis pathway, providing a new basis for the mechanism and targeted therapy of HFsnEF.

BACKGROUND:Acupuncture is effective for chronic insomnia disorder (CID), but the favorable treatment duration remains uncertain, and direct evidence comparing different treatment courses is limited. This study compared the effectiveness of 4-, 6-, and 8-week acupuncture courses to determine whether extending treatment provides additional clinical benefit. METHODS:In this three-arm randomized controlled trial, 201 patients with CID were randomly assigned (1:1:1) to receive 4, 6, or 8 weeks of acupuncture (n = 67 per group), administered three times weekly using the same acupoints. The primary outcome was the the Insomnia Severity Index (ISI) score at treatment completion. Secondary outcomes included clinical remission (ISI < 8), and a minimal clinically important difference (ISI-MCID reduction ≥6), as well as scores on the Pittsburgh Sleep Quality Index (PSQI), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), and Fatigue Severity Scale (FSS), hypnotic medication use, and safety. Outcomes were assessed at baseline, treatment completion, and 1 and 3 months after treatment. Longitudinal continuous outcomes were analyzed using linear mixed-effects models under the intention-to-treat principle. RESULTS:A total of 201 patients (157 women [78.1%], 44 men [21.9%]) were included in the intention-to-treat analysis. ISI scores decreased from baseline to post-treatment in the 4-, 6-, and 8-week groups, with mean changes of -7.4 points (95% CI, -9.0 to -5.8; P < .001), -9.7 points (95% CI, -11.4 to -8.0; P < .001), and -10.0 points (95% CI, -11.7 to -8.3; P < .001), respectively. Compared with the 4-week group, the 6- and 8-week groups showed greater improvements in ISI scores, with adjusted mean differences of -2.7 points (95% CI, -4.8 to -0.6; P = .008) and -2.8 points (95% CI, -4.9 to -0.6; P = .006), respectively. The additional improvement with the 8-week course versus the 6-week course was limited, with an adjusted mean difference of 0.0 points (95% CI, -2.2 to 2.1; P > .99). Clinical remission and MCID were more frequent in the 6-week group than in the 4-week group (P = .003 and P = .010, respectively). Sleep quality also generally favored the 6-week course over the 4-week course, with an adjusted mean difference of -1.9 points (95% CI, -3.6 to -0.2; P = .02). Between-group differences in depressive and anxiety symptoms were observed mainly between the 8- and 4-week groups. However, these secondary findings should be interpreted cautiously. No significant between-group differences were observed in fatigue or hypnotic medication use. No serious adverse events were reported. CONCLUSION:Six- and 8-week acupuncture courses produced greater improvements in insomnia severity than a 4-week course in patients with CID. Extending treatment from 6 to 8 weeks provided limited additional benefit for core sleep outcomes. These findings may inform clinical decisions regarding acupuncture treatment duration for CID. TRIAL REGISTRATION:https://www.chictr.org.cn [ChiCTR2300073711].

Purpose:Evaluating allergen immunotherapy efficacy amidst natural pollen fluctuations is complicated by pollen variation. This study evaluates the relationship between pollen exposure and therapeutic impact of Artemisia annua sublingual immunotherapy (SLIT) in seasonal allergic rhinitis (SAR). Patients and Methods:In a two-year multicenter, controlled trial, SAR patients sensitized to Artemisia received SLIT or symptomatic medication. Daily assessments of combined symptom and medication score (CSMS), total nasal symptom score (TNSS) and daily medication score (DMS), were conducted across two pollen seasons. Linear mixed-effect models (LMMs) were utilized to evaluate treatment effects while considering pollen variability. Exploratory analyses of immunoglobulins in serum and nasal secretions were performed. Results:Pollen fluctuations correlated positively with CSMS, TNSS, and DMS in both groups. SLIT significantly reduced the mean daily CSMS (β = -0.34, q < 0.001), TNSS (β = -1.01, q < 0.001), and DMS (β = -0.09, q < 0.001) compared to the control group. These effects were consistent across both pollen seasons. During the first pollen season, a significantly negative impact of group × time × pollen interactions on the average daily CSMS was observed in SLIT group (β = -0.11, P = 0.03). LMM analyses revealed significant group × time interactions for serum Artemisia-specific IgG4 and IgA with nasal IgA showing isolated significance. Conclusion:SLIT provided early and sustained symptom relief in SAR, taking into account the annual and seasonal pollen fluctuations. SLIT efficacy may be influenced by pollen exposure, with effect size increasing in correlation with higher levels of pollen exposure. SLIT elevated allergen-specific IgG4 and IgA in systemic and local compartments.

In China, Artemisia pollen is one of the most prevalent allergens in late summer and autumn, especially in northern regions, causing various clinical symptoms and significantly affecting patients' quality of life. Currently, clinical diagnosis and allergen immunotherapy (AIT) for Artemisia pollen allergy rely on crude pollen extract, whose effectiveness varies depending on the source of the pollen, extraction methods, and storage conditions. Our previous study demonstrated that the allergenicity of Artemisia pollen extract is primarily related to the content of major allergens. Among the ten allergen components identified, the defensin-like protein (Art v 1 homologues), non-specific lipid transfer protein (Art v 3 homologues, nsLTP) and putative galactose oxidase (Art an 7) are the major allergens in Chinese patients. Allergy diagnosis and treatment using allergen extracts are dose-dependent, so it is crucial to quantify the clinically relevant allergen components using reliable standardized methods. In this study, Artemisia annua pollens were collected from various regions over several years. Two methods of extraction and various preparations of pollen extracts from different Artemisia pollen species and manufacturers were compared for total protein content. Sandwich ELISA (Enzyme-linked immunosorbent assay) methods were developed and applied for the quantification of major allergen components Art v 1, Art v 3, and minor pan-allergen profilin Art v 4 in Artemisia pollen extracts with highly purified allergen components serving as standards. The total protein content and concentrations of the three important allergen components in crude extracts did not vary significantly across Chinese regions or in different years, nor with the extraction methods. However, concentrations of three allergen components differed significantly in A. annua pollen sourced from Kazakhstan versus China. Notably, total protein content and the allergen component concentrations varied significantly in different Artemisia species and those obtained from different manufacturers. The content of Art v 1 and Art v 3 homologues in pollen extracts were significantly higher than Art v 4. In general, the contents of nsLTP were notably lower in the extract derived from A. sieversiana thanA. annua. In the commercial extracts, Art v 1 homologues content varied four-fold (2.9%-12.2%), and Art v 3 homologues 18-fold (0.6%-11.4%). Furthermore, Art v 4 homologues were only detected in three of the nine extracts. Standardized main allergen components in the allergen extracts are essential for improving the sensitivity and safety of clinical diagnosis and treatment. There is a pressing need for the harmonization and standardization of Artemisia pollen extracts in China. Allergen standardization is a complex process requiring extensive effort. Our study developed a highly sensitive ELISA method for quantifying three main allergen components in Artemisia pollen extracts. Standard quantification of other allergen components is under development. This will facilitate the standardization of Artemisia pollen extracts and improve the efficiency of clinical diagnosis and treatment.

Fruit allergy is a significant and increasingly recognized global health concern: once reported as a problem in Europe, it is now relevant in many countries, especially China, as consumption in both variety and quantity has increased dramatically. It is often associated with pollen allergy, with clinical manifestations ranging from localized oral allergy syndrome (OAS) to severe systemic reactions such as anaphylaxis. The majority of fruit allergens belong to a limited number of protein families each exhibiting distinct biochemical properties and clinical relevance. Allergy diagnosis relies on a detailed clinical history supported by in vivo and/or in vitro measurements. Component-resolved diagnosis (CRD) with purified allergen molecules provides insight into the primary sensitizing molecules and a more precise and standardized identification of sensitization patterns than possible with extract-based tests. Allergy management focuses on strict avoidance of trigger fruits, while prevention involves breeding hypoallergenic cultivars with lower allergen content and food processing technologies to reduce allergenicity. Allergen immunotherapy (AIT) has been explored as a treatment for fruit allergy with indications of improved tolerance. Emerging approaches combining AIT with biologic agents may further enhance treatment outcomes, although these novel strategies require additional research.

BackgroundPollen-induced allergic rhinitis (PIAR) is a major public health burden in high-pollen regions of northern China (e.g., Ordos, southern Inner Mongolia Plateau). However, regional variations in PIAR across ecological zones (urban, agropastoral, desert, and mining zones), dominant allergens, and key risk factors remain understudied due to prior small-sample or narrow-scope research.ObjectiveThis study aimed to investigate the prevalence, major risk factors, and current treatment patterns for PIAR in Ordos.MethodsFrom March to July 2023, a multicenter, randomized, stratified cross-sectional survey was conducted across nine areas in Ordos. Participants were recruited to complete in-person questionnaires and undergo skin prick tests (SPTs) for 16 common allergens. Pollen was collected and counted to monitor exposure levels.ResultsAmong the 4,303 participants, the prevalence rates of self-reported allergic rhinitis (SRAR), physician-diagnosed allergic rhinitis (PDAR), and PIAR were 52.89% (2,276/4,303), 34.70% (1,493/4,303), and 31.51% (1,356/4,303), respectively. The prevalence rates of PIAR in urban, agropastoral, desert, and mining areas were 30.46%, 39.55%, 29.09%, and 19.72%, respectively. Among patients with PIAR, the incidence of symptom onset was highest among urban residents and lowest among mining area residents. Poplar pollen allergen dominated in spring, whereas in autumn, Artemisia pollen was predominant. Clinical symptoms were greatest in July, preceding the autumn pollen peak in September.ConclusionPIAR is highly prevalent in northern China's grasslands, with marked zone-specific variations. Artemisia pollen exposure is the main sensitization driver, supporting targeted PIAR prevention/control.

IntroductionAcupuncture has shown significant therapeutic effects for functional dyspepsia (FD) in clinical trials. However, clinical observations reveal substantial variations in patient responses to acupuncture. In addition to patient-related factors, such variability may also be associated with differences in acupuncturists’ clinical experience. This study compared the treatment outcomes for FD between junior and senior acupuncturists.Materials and methodsThis exploratory secondary analysis used data from a previous randomized controlled trial. Patients were divided into two groups based on acupuncturists’ years of practice as defined by the professional title evaluation rules, using 5 years as the cut-off (Group A treated by junior acupuncturists and Group B treated by senior acupuncturists). Outcome measures included the Symptom Index for Dyspepsia (SID), the four cardinal symptoms of FD, and the Nepean Dyspepsia Life Quality Index (NDLQI). Assessments were conducted at baseline, treatment weeks 2 and 4, and follow-up weeks 4 and 12. Data were analyzed using generalized estimating equations.ResultsAdjusted analyses were performed after including items with between-group differences as covariates. The study revealed that Group B had lower SID scores than Group A at both follow-up time points—at 4 weeks (mean difference: 0.6, p = 0.007) and at 12 weeks (mean difference: 0.8, p = 0.001). In addition, Group B showed greater improvements in postprandial fullness and early satiety at both follow-ups (p < 0.010). However, no significant between-group differences were observed for epigastric pain or epigastric burning. Regarding quality of life, Group B also had higher NDLQI scores at the 12-week follow-up (mean difference: −2.9; p = 0.041).ConclusionBased on the 5-year administrative cutoff criterion, this exploratory secondary analysis found a potential association between acupuncturists’ years of practice and acupuncture efficacy for FD, but prospective studies are needed for confirmation.

Background Allergen specific immunotherapy (AIT) is a guideline-approved treatment that can modify the course of allergic rhinitis (AR). The treatment regimen for AIT in pollen-induced AR is more complex due to the impact of pollen exposure and there is no uniform recommendation on the time to initiate AIT for pollen-induced AR. Objective The aim of this study was to investigate whether the initiation timing pre- or post-pollen season (PS) influence efficacy of Artemisia Annua sublingual immunotherapy (SLIT) in patients with allergic rhinitis. Methods This was an open-label multicenter clinical trial. We recruited eligible patients in March 2022 and November 2022 from 3 treatment centers, and initiated SLIT before and after the PS of Artemisia Annua in 2022. Meanwhile, a control group was also set up to receive rescue medicine. Symptoms and medication usage were assessed throughout the PS, efficacy of SLIT was evaluated by comparing changes from baseline in: 1) the combined symptom-medication score (CSMS), 2) total nasal symptom score (TNSS), 3) ocular symptom score (TOSS), and 4) medication score (MS). A linear mixed-effects model (LMM) was employed to analyze the effects of treatment (SLIT vs. control), treatment initiation timing (pre-vs. post-season) on therapeutic outcomes. Results SLIT significantly alleviated symptoms and reduced medication use compared to control, regardless of whether initiation before or after the PS. Furthermore, the LMM indicated that initiation timing (pre-vs. post-season) did not significantly affect treatment efficacy. There was no significant interaction effect between initiation timing and treatment group. It was also shown that higher pollen concentration was significantly associated with worse symptom severity and increased medication use. Conclusion This multi-center study further confirms the efficacy of SLIT for Artemisia Annua-induced AR. We demonstrated that initiating SLIT before or after the PS did not affect its therapeutic efficacy by using LMM. This finding addresses a gap regarding the optimal timing for SLIT initiation and provides crucial evidence to inform clinical decision-making, offering greater flexibility in treatment scheduling. Clinical trial registrations NCT05318157; Registered March 22, 2008.

INTRODUCTION:Patients with coronary artery disease (CAD) have diminished tolerance for gastrointestinal endoscopy procedures (upper/lower) performed under deep sedation, resulting in increased incidence rates of hypotension and myocardial ischaemia among these patients. Avoiding hypoxemia caused by deep sedation and increased oxygen consumption caused by inadequate sedation is particularly important in these patients. Based on recent data indicating that high-flow nasal oxygen therapy (HFNO) is beneficial for preventing hypoxaemia in high-risk patients, this study investigated whether HFNO can improve myocardial oxygen supply during gastrointestinal endoscopy under deep sedation. Using cardiac cycle efficiency (CCE) data from MostCare to assess myocardial oxygen supply-demand balance in patients with CAD, we tested the hypothesis that compared with standard oxygen therapy (SOT), HFNO can improve CCE in patientswith CAD during gastrointestinal endoscopy under deep sedation. METHODS AND ANALYSIS:This single-centre randomised controlled trial will compare the effects of HFNO and SOT among CAD patients during gastrointestinal endoscopy under deep sedation administered by anaesthesiologists. 90 patients will be randomly allocated in a 1:1 ratio to two parallel groups. The primary outcome will be the difference in CCE between the two groups during sedation. Secondary outcomes will include the incidence of hypotension; the occurrence of hypoxemia; brain natriuretic peptide, troponin I and lactate levels at 6-12 hours postoperation; frequency of patient agitation episodes; intraoperative adverse memory recall; need for mask ventilation or any airway intervention; duration of sedation; HFNO-related adverse events; and MostCare haemodynamic parameters other than the primary outcome. ETHICS AND DISSEMINATION:This study has been approved by the Ethics Committee of Beijing Anzhen Hospital, Capital Medical University (KS2024066), and patients will be included after providing informed consent. The results will be submitted to a peer-reviewed journal for publication. TRIAL REGISTRATION NUMBER:ChiCTR2400086887.

Introduction: Artemisia pollen is a major aeroallergen source in Northern China that can cause multiple kinds of common allergic diseases. China's first Artemisia annua sublingual drops for Artemisia pollen-induced seasonal allergic rhinitis were launched in 2021. This study aimed to evaluate the efficacy and safety of a 2-year course of sublingual immunotherapy (SLIT) using A. annua allergen extract in patients with seasonal allergic rhinoconjunctivitis (SARC). Additionally, it sought to assess the sustained clinical efficacy of this therapy 1 year post-treatment. Methods: Fifty patients (aged 4-60 years) with SARC and confirmed A. annua pollen allergy were enrolled in this study. In accordance with their preferences, the subjects were assigned to either the SLIT group (n = 25, receiving SLIT plus symptomatic treatment) or the control group (n = 25, receiving symptomatic treatment alone) at a ratio of 1:1. The entire study lasted for 3 years, initiating a 2-year treatment phase (2022 and 2023 pollen seasons) followed by a 1-year post-discontinuation follow-up period (2024 pollen season), with 2021 pollen season regarded as baseline. The total rhinoconjunctivitis symptom score (TRSS), total medication score (TMS), combined score of medication and rhinoconjunctivitis symptoms (CSMRS), and visual analogue scale (VAS) were compared between the two groups for clinical efficacy. In addition, the rhinoconjunctivitis quality of life questionnaire (RQLQ) was used to assess the impact of the A. annua SLIT on the quality of life of patients. Safety was evaluated based on adverse events. Results: A total of 41 patients completed the study (SLIT: n = 21, control: n = 20). There were no significant differences between the two groups during 2021 pollen season (baseline). However, the scores of TRSS (all p < 0.001), CSMRS (all p < 0.001), VAS (2022: p < 0.01; 2023: p < 0.001; 2024: p < 0.001), and RQLQ scores (2022: p < 0.01; 2023: p < 0.001; 2024: p < 0.001) were significantly lower than the control group during the 2-year SLIT treatment period and 1-year follow-up period. For TMS scores, although no statistically significant differences were found in 2022 and 2023 pollen seasons (p > 0.05), the SLIT group showed a decreasing trend. And TMS of SLIT group was significantly lower than that of the control group during 2024 pollen season (p < 0.05). In addition, RQLQ scores correlated positively with CSMRS and VAS (all p < 0.001). Conclusions: A 2-year course of SLIT with A. annua allergen extract significantly alleviated symptoms and reduced medication use in SARC patients, with clinical benefits persisting for at least 1-year post-treatment phase.

Piezo ion channels, notably Piezo1 and Piezo2, are key mechanosensors that transduce mechanical forces into intracellular signals, playing indispensable roles in digestive physiology. These channels regulate essential functions such as intestinal motility, epithelial barrier integrity, bile secretion, and host-microbiota balance. Emerging evidence links aberrant Piezo signaling to a wide range of gastrointestinal disorders, including functional bowel diseases, inflammatory conditions, and digestive cancers. However, translating these insights into therapeutic applications remains challenging. Most current findings are derived from animal models or in vitro studies, which do not fully recapitulate human tissue complexity. Advanced human-relevant platforms, such as organoids and organ-on-a-chip systems, are needed to bridge this translational gap. Furthermore, Piezo1 and Piezo2 play both overlapping and distinct roles in gastrointestinal pathophysiology, necessitating selective modulation strategies. While Piezo1 promotes processes such as epithelial remodeling and tumor invasion via pathways like RhoA/ROCK and YAP/TAZ, Piezo2 is more associated with sensory neuron activity, immune modulation, and tumor aggressiveness. The lack of specific agonists and inhibitors, especially for Piezo2, further limits its clinical translation. Lastly, Piezo channels are deeply integrated into complex molecular networks involving focal adhesions, cytoskeletal dynamics, and transcriptional regulation. This review synthesizes current advances in the mechanobiology of Piezo channels within the digestive system and highlights future directions for mechanistically-informed, Piezo-targeted therapies.

Allergic rhinitis (AR) is a prevalent inflammatory condition of the nasal mucosa, characterized by rhinorrhea, nasal congestion, sneezing, and itching. Among these symptoms, rhinorrhea and nasal congestion are the most common complaints of AR patients. By blocking acetylcholine binding with muscarinic (M) receptors, intranasal anticholinergics have been recommended by guidelines as an "add-on" or second-line therapy to control rhinorrhea in patients with AR. Bencycloquidium bromide is a highly selective M1/M3 receptor antagonist that can reduce excessive mucus secretion and suppress type 2 inflammation in AR, while also demonstrating efficacy in alleviating overall nasal symptoms. In this consensus, we systematically review the role of acetylcholine and M receptors in AR pathogenesis, the key findings from clinical trials on intranasal anticholinergics for AR management and the evidence-based recommendations from experts in Allergy and Rhinology, hoping to guide physicians in the standardized and precise use of intranasal anticholinergics for AR patients.

Originally native to North America, ragweed has become a pervasive invasive species worldwide over the past century, posing a substantial public health risk as a potent allergen. This review explores the key allergens found in common ragweed, assesses global trends in ragweed sensitization, particularly in China, and examines various therapeutic and biological control methods. There are currently 11 identified ragweed allergens, with Amb a 1 and 11 recognized as the primary triggers. Epidemiological data indicate higher rates of sensitization in North America and Europe, with a growing trend observed in China. Ragweed-induced type I hypersensitivity typically presents as seasonal allergic rhinitis, conjunctivitis, and asthma symptoms. Strategies for managing ragweed allergy include allergen avoidance, pharmacotherapy, and allergen immunotherapy (AIT). Biological control using Ophraella communa and Epiblema strenuana effectively limits ragweed proliferation. Accurate allergen identification and personalized treatment can significantly reduce the health burden associated with ragweed. An in-depth understanding of ragweed sensitization patterns and biological control measures is essential for the long-term prevention of ragweed allergies.

INTRODUCTION:In Beijing, China, the key pollen allergen components associated with spring allergic rhinitis (AR) and their potential link to pollen-food allergy syndrome (PFAS) remain incompletely characterized. This study aimed to identify the major pollen allergens that trigger AR in spring and the key pollen components that drive PFAS in Beijing. METHODS:A total of 125 patients with spring AR symptoms were enrolled during the spring pollen season in Beijing. Serum-specific IgE against pollen allergen components and food allergens was detected using ImmunoCAP and enzyme-linked immunosorbent assay. Inhibition assays were performed to verify cross-reactivity between pollen and food proteins. SPSS 26.0 software was used to analyze the correlation between pollen allergen components and PFAS-related food sensitization. RESULTS:Among the 125 allergic patients, the main spring pollen allergens were cypress, Fraxinus chinensis, plane tree, willow, Populus, white birch and elm, while Artemisia sieversiana, sunflower, and goosefoot were the main autumn pollen allergens. The highest positive rate of Cup a 1 (60.9%) was observed for cypress, the highest positive rate of Art an 2 (64.8%) for Artemisia annua, and the highest positive rate of Che a 2 (80%) for goosefoot. Spearman's correlation analysis indicated that Art an 4 cross-reacted with peach (r = 0.766, p < 0.0001), and Che a 2 cross-reacted with peach (r = 0.914, p < 0.001), which were confirmed by inhibition assay. CONCLUSION:Spring AR patients should be alert for the possible cross-reactivity to some food and autumn pollen allergy. We found Art an 4 profilin sensitization has much impact on peach Pru p 4 and goosefoot pollen Che a 2 positivity, highlighting the need to detect both spring and autumn pollen components for early PFAS risk screening in spring.

Background:Pollen immunotherapy has increasingly gained attention in China. However, the majority of existing research is limited to evaluating therapeutic effects within a 1-year treatment period, with insufficient evidence regarding the longer-term course of treatment. Objectives:Our study was designed to evaluate the clinical effectiveness and safety of 2-year Artemisia annua sublingual immunotherapy (SLIT) treatment in allergic rhinoconjunctivitis (ARC) patients of all ages. Methods:This study was conducted as a nonblind randomized controlled trial. Fifty eligible patients (7-57 years old) sensitized to Artemisia pollen were randomized into SLIT (n = 25) and control groups (n = 25). The SLIT group administered daily Artemisia annua SLIT for 2 years, and the control group only accepted symptomatic medications. Clinical outcomes including total rhinoconjunctivitis symptom score (TRSS), total medication score (TMS), combined scores of medication and rhinoconjunctivitis symptom (CSMRS), and the visual analog scale (VAS) scores were assessed across 3 consecutive pollen seasons (2021 as baseline, followed by 2022 and 2023). Additionally, the occurrence of adverse events (AEs) was used to evaluate its safety. Results:Finally, 43 patients (SLIT: 21, control: 22) completed this study. When compared with the control group, the patients in SLIT group exhibited remarkable improvements in TRSS, TMS, CSMRS, and VAS scores during the 2023 pollen season (P < 0.001). Especially, more patients in the SLIT group showed greater improvement in symptoms, medication use, and the overall situation. Notably, no severe AEs were reported throughout the whole study. Conclusions:Two years of Artemisia annua SLIT treatment was effective and well-tolerated in patients with ARC, confirmed by their improved symptoms and reduced medication use.

BACKGROUND:To comprehensively assess the effectiveness of different drug treatment regimens for acute asthma in children in North China (Beijing Tianjin and Hebei). METHODS:Computer searches were conducted on PubMed, Cochrane library, Embase, Web of Science, Wanfang database, Chinese Academic Journal Full Text Database, and VIP Chinese Journal Full Text Database. We searched randomized controlled trials where the control group was conducted on the treatment of acute asthma in children in the North China region (Beijing Tianjin Hebei) using one single drug which was corticosteroids or adrenergic agonist of β2 receptor, while the observation group received a combination of two. This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. RESULTS:Five randomized controlled trials were included in this meta-analysis, comprising a total of 398 patients (198 in control group and 200 in experimental group). Analysis of clinical efficacy, including all 5 studies, exhibited the total efficacy of combination therapy (relative risk = 5.41, 95% confidence interval [CI] = 2.56-11.42) was superior to the use of glucocorticoids alone or β2 receptor agonist drugs (P < .01) with low heterogeneity (I² = 0%, P > .1). The occurrence of adverse reactions in combination therapy (relative risk = 0.18, 95% CI = 0.02-1.45) appeared lower than that of using corticosteroids alone or β2 receptor agonist drugs, but the difference was not statistically significant (P > .01) with moderate heterogeneity (I² = 54%, P > .1). The symptom disappearance time of combination therapy (mean difference = -1.34, 95% CI = -2.00 to -0.69) was significantly shorter than that of single use of corticosteroids or β2 receptor agonist drugs (P < .01) with substantial heterogeneity (I² = 95%, P < .1). CONCLUSION:The combination of glucocorticoids and β2 receptor adrenergic agonists in acute asthma treatment in children may provide improved therapeutic outcomes compared to monotherapy, with potentially higher treatment effectiveness and shorter symptom relief time. However, these findings should be interpreted with caution due to the small number of included studies, significant heterogeneity in some outcomes, and limited long-term data. Further, high-quality studies with larger sample sizes and longer follow-up periods are needed to establish definitive recommendations for clinical practice.

Domain-specific LLMs in TCM face limitations in research settings due to constrained adaptability, insufficient evaluation datasets, and limited computational resources. This study presents TianHui, a specialized TCM LLM built through contextual data integration and domain knowledge fusion. We constructed a large-scale TCM corpus (0.97GB unsupervised data + 611,312 QA pairs) and employed a two-stage training strategy with QLoRA, DeepSpeed Stage 2, and Flash Attention 2. Evaluation on 12 benchmarks showed TianHui ranked top-three in all metrics for six datasets (APQ, TCMCD, HFR, HCCA, DHPE, TLAW) and achieved top results in the other six (TCMEE, APR, GCPMI, TCMKQA, TCMRC, ADTG). Optimal configuration was identified as LoRA rank=128, alpha=256, epoch=4, dropout=0.2, max length=2048. TianHui enables systematic preservation and scalable application of TCM knowledge. All resources are open-sourced.

Background:Seasonal allergic rhinitis triggered by Cupressaceae species is a significant concern worldwide, particularly in regions such as Japan, China, Spain, and the United States. Objective:This study investigated specific IgE responses to Cupressaceae species and the potential clinical relevance of cross-reactivity, focusing on Japanese cedar (Cryptomeria japonica [Cry j]), which is a major allergenic species in Japan. Methods:We analyzed serum samples from 609 patients across 4 countries to measure levels of specific IgE using ImmunoCAP. We assessed IgE reactivity against Cry j extract and other Cupressaceae species, including Arizona cypress and red cedar extracts, to delineate patterns of reactivity. Results:Levels of specific IgE against Cry j were markedly elevated in Japanese samples; they were nearly 10-fold higher than those against other allergens. In contrast, samples from China, Spain, and the United States showed lower levels of Cry j-specific IgE, with significant levels of reactivity against Cupressus arizonica and mountain cedar (Juniperus ashei) species. Inhibition assays demonstrated that Cry j extract significantly inhibited IgE binding, particularly in Japan, suggesting dominant Cry j-specific antibodies, whereas cross-inhibition was lower in other countries. Geographic differences in pan-allergen reactivity were observed, with a notable prevalence of profilin and cross-reactive carbohydrate determinant-specific IgE in samples from the United States but minimal reactivity in samples from Japan and China. Conclusion:These findings indicate notable geographic variations in specific IgE reactivity and cross-reactivity among Cupressaceae species, thus underscoring the importance of tailoring diagnostic and therapeutic approaches in allergy treatment based on region-specific allergen exposure patterns.