Volume 106 ·  Issue 16 ·  2026

To investigate the characteristics of 14 arachidonic acid (AA) metabolites in the serum of patients with allergic bronchopulmonary aspergillosis (ABPA), screen for differential metabolic biomarkers that can distinguish it from severe allergic asthma (SA), and construct a diagnostic model.

A cross-sectional study was conducted. A total of 19 patients with ABPA, 19 patients with SA, and 19 healthy controls (HC) from the First Affiliated Hospital of Guangzhou Medical University between December 2024 and July 2025 were enrolled as the training set. Additionally, a validation set consisting of 12 SA patients and 12 ABPA patients was recruited from the same center between September to December 2025. Peripheral blood cell counts and immunological and biochemical parameters were measured in all participants. Absolute quantification of 14 AA metabolites in serum was performed using ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) based on 5-(diisopropylamino) pentylamine derivative. Differences among groups were compared to identify significantly altered metabolites. In the training set, a combined clinical and metabolic indicator model was constructed using binary logistic regression. The diagnostic performance, calibration and clinical utility of the model were evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis, respectively. The model was further validated in the validation set.

A total of 19 patients in the ABPA group were enrolled, aged 45 (33, 60) years, with 12 males; 19 patients in the SA group were aged 39 (29, 47) years, with 11 males; and 19 subjects in the HC group were aged 43 (34, 52) years, with 11 males. Compared with the SA group, patients with ABPA exhibited significantly higher levels of total IgE [1 578.00 (1 346.00, 2 538.00) U/ml vs 599.30 (382.20, 1 462.00) U/ml] and Aspergillus fumigatus-specific IgE (Af.sIgE) [4.93 (0.95, 8.41) kUA/L vs 0.27 (0.13, 2.17) kUA/L] (both P<0.05). Serum levels of arachidonic acid (AA), prostaglandin D₂ (PGD₂), leukotriene B₄ (LTB₄), 5-hydroxyeicosatetraenoic acid (HETE), 12-HETE, and 15-HETE were significantly higher in the ABPA group than in the HC group (all P<0.05). Moreover, PGD₂ [1.80 (0.82, 2.13) μg/L vs 0.63 (0.37, 1.15) μg/L] and 15-HETE levels [16.39 (11.15, 20.41) μg/L vs 9.31 (6.57, 10.86) μg/L] were significantly elevated in the ABPA group compared with the SA group. A four-indicator combined diagnostic model incorporating total IgE, Af.sIgE, PGD₂, and 15-HETE was constructed. In the training set, the area under the curve (AUC) of the four-indicator combined model was 0.96 (95%CI: 0.92-1.00), with a sensitivity of 0.93 and specificity of 0.95. In the validation set, the AUC was 0.91 (95%CI: 0.81-1.00), with a sensitivity of 0.92 and specificity of 0.83. Calibration curves showed good consistency for the four-indicator model across all datasets, and decision curve analysis indicated favorable clinical applicability.

ABPA patients exhibit characteristic AA metabolic disorders, and their characteristically elevated serum PGD2 and 15-HETE are potential specific biomarkers for differentiating ABPA from SA. The constructed four-indicator combined model including total IgE, Af.sIgE, PGD₂, and 15-HETE has good diagnostic efficacy in differentiating ABPA from SA.

To investigate the efficacy and optimal timing of prophylactic medication before pollen season for children with seasonal allergic rhinitis (AR) and allergic asthma (AA) in Hohhot.

A prospective, self-controlled study was conducted. Children aged 4-14 years who were diagnosed with AR or AR+AA in Hohhot First Hospital from January to August 2024 were enrolled, with the same patients undergoing self-medication in 2024 pollen season as the controls. Before 2025 pollen season, children were stratified into eight groups based on disease type (AR/AR+AA), severity of disease (mild/moderate-severe), and onset season (spring/autumn). For each group, prophylactic medication was initiated at 5, 10, 15, and 20 days before the season, respectively. Symptom onset time, symptomatic days, visual analogue scale (VAS) score, total medication score (TMS), and childhood asthma control test (C-ACT) score were compared between the two groups.

A total of 312 children were included in the study, consisting of 183 males (58.7%) and 129 females (41.3%), with a mean age of (8.6±3.0) years. After initiating medication 5, 10, and 15 days before the season for mild spring, moderate-severe spring and mild autumn, and moderate-severe autumn AR cases, respectively, children experienced significantly shorter symptomatic periods and lower VAS scores than those in the self-medication group (all P<0.01). For children with AR+AA, clinical indicators (symptomatic days, VAS score, and C-ACT score) were significantly improved after initiating medication 15 days in advance for mild spring cases and 20 days in advance for other subgroups (all P<0.01). The proportions of pre-season symptoms in the prophylactic medication groups were lower, and TMS scores were higher (all P<0.01).

Stratified prophylactic medication based on disease severity before the pollen season can delay symptom onset, alleviate symptom severity, and shorten the duration of symptoms in children with AR and AA.

Preliminary analysis of dynamic expression characteristics of plasma proteins in children with allergic asthma during subcutaneous immunotherapy (SCIT) with dust mite allergens based on multi-time-point proteomics technology.

A cross-sectional study was conducted, enrolling 84 children with allergic asthma primarily sensitized to house dust mites (HDM) who visited the Children′s Hospital of Soochow University between November 2024 and May 2025. Participants were categorized into five groups based on the duration of SCIT: 0M, 3M, 6M, 12M, and 24M. To detect the levels of specific immunoglobulin E (sIgE) and specific immunoglobulin G4 (sIgG4) against dust mite components (Der p1, Der f1, Der p2, Der f2, Der p5, Der p7, Der p10, Der p21, Der p23). Five subjects were randomly selected from each group using simple random sampling, and an additional 5 healthy children (HC) were included as the control group for plasma proteomic analysis. The temporal expression patterns of differentially expressed proteins were clustered via the Mfuzz algorithm and subjected to functional annotation.

A total of 84 children were enrolled, with a mean age of (10.12±2.15) years, including 57 males and 27 females. Statistically significant differences were observed in Der p1-, Der f1-, Der p2-, and Der f2-specific IgG4 levels among the five groups (all P<0.05). The 24M group exhibited significantly higher levels of Der p1-, Der f1-, Der p2-, and Der f2-specific IgG4 compared with the 0M group [Der p1: 695.20 (57.85, 1 894.60) vs 44.35 (32.10, 51.10); Der f1: 70.15 (51.35, 1 141.03) vs 46.65 (35.30, 63.68); Der p2: 3 440.20 (892.20, 4 183.00) vs 66.85 (43.08, 189.98); Der f2: 2 015.50 (704.60, 2 523.10) vs 69.10 (45.80, 159.35), all P<0.05]. Enrichment analysis of differentially expressed proteins in each group using the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway database showed that: compared with the healthy control group, the 0M group exhibited upregulation of cholesterol metabolism and complement/coagulation cascades, and downregulation of cornified envelope formation and ECM-receptor interaction pathways. compared with the 0M group, the 3M group showed upregulation of ECM-receptor interaction and focal adhesion and downregulation of fatty acid metabolism. The 6M group showed upregulation of cell adhesion molecules and downregulation of cholesterol metabolism; the 12M and 24M groups showed upregulation of TGF-β and PI3K-Akt pathways. Fuzzy C-means clustering analysis revealed that proteins highly expressed in the 6M group were enriched in glutathione metabolism, while those in the 24M group were significantly enriched in B cell-mediated immune responses. Six potential regulatory proteins (ARPC3, LPL, ILF3, FARSB, USP14, and SLIT2) were initially identified. Furthermore, Spearman correlation analysis revealed that ARPC3 was significantly negatively correlated with the levels of Der f2-sIgE, Der p2-sIgG4, and Der f2-sIgG4 (r=-0.44, -0.57, -0.54, respectively, all P<0.05). Additionally, ILF3 was positively correlated with Der p21-sIgE (r=0.57, P<0.01), FARSB was negatively correlated with Der p2-sIgG4 (r=-0.44, P<0.01), and USP14 was negatively correlated with Der f1-sIgE (r=-0.46, P<0.05).

Differences exist in allergen antibody and plasma protein expression profiles among children with allergic asthma across groups with different durations of SCIT. The differentially expressed proteins may be involved in pathways related to airway epithelial barrier, metabolic homeostasis and immune regulation.

To investigate the molecular sensitization profiles of inhalant allergens in Chinese patients with airway allergies using component-resolved diagnosis (CRD) and to analyze their distributional characteristics.

In this cross-sectional study, allergen component testing data were collected from 225 patients diagnosed with allergic rhinitis (AR) and/or allergic asthma (AS) across 20 medical centers in 13 provinces (Northern, Southern, and Northwestern China) between October 2019 and January 2023. Specific immunoglobulin E (sIgE) levels for 132 components were analyzed. Sensitization differences were compared across clinical phenotypes, age stratifications, and geographical regions. Spearman correlation analysis was employed to evaluate molecular cross-reactivity.

Among the 225 patients [mean age: (19.40±17.53) years; 119 males, 106 females], children aged 0-6 and 7-14 years accounted for 58.67% (132/225). Regarding overall distribution, the predominant sensitizing components were Artemisia vulgaris (Art v 1, 43.11%), dust mites (Der p 2, 39.11%; Der f 2, 38.22%), and Phleum pratense (Phl p 12, 39.11%). Phenotypically, while the AR combined with AS group exhibited the broadest polysensitization, the AR only group was distinct for its significantly higher sensitization to cat (Fel d 1, 68.42%) and dog (Can f 1,36.84%) dander (both P<0.05). Conversely, pollen sensitization was relatively lower in the AS only group. Regarding age, children (0-6 and 7-14 years) showed early sensitization to pan-allergens (e.g., Phl p 12, Bet v 2) and fungi (Alt a 1), whereas dust mite components (Der f 2, Der p 2, Der p 23) showed lower prevalence in the 0-6 group (23.19%, 23.19%, and 10.14%, respectively). Regional analysis highlighted a "Northern Pollen vs Southern Mite" dichotomy: weeds (Artemisia>60%) and tree pollen dominated the Northwest and North, whereas mites (>60%) and cockroaches dominated the South (P<0.001). Furthermore, extensive molecular cross-reactivity was confirmed within the Serum Albumin and Profilin families.

Significant heterogeneity exists in sensitization profiles across phenotypes, ages, and regions. Mugwort and mites are core allergens. CRD facilitates the identification of cross-reactivity and guides precise, regionalized management.

To investigate the effects of perioperative transcutaneous auricular vagus nerve stimulation (taVNS) on postoperative pain and early sleep quality in patients undergoing glaucoma surgery under general anesthesia.

A total of 94 hospitalized patients scheduled for elective glaucoma surgery under general anesthesia at Beijing Tongren Hospital, Capital Medical University, from April to August 2024 were prospectively enrolled and randomly assigned using a random number table to either the taVNS group (n=47) or the sham stimulation group (s-taVNS group) (n=47). In the taVNS group, active electrical stimulation was applied to the left auricular concha area starting from 2 days before surgery, while the s-taVNS group received electrode placement without current output. Stimulation was performed twice daily for 30 min each session until the first postoperative day. The primary outcome was the incidence of moderate to severe pain within 24 hours after surgery, defined as a Numeric Rating Scale (NRS) score≥4 score. Secondary outcomes included NRS scores at different time points, use of rescue analgesics, insomnia severity index (ISI) scores. Comparisons were made between the two groups regarding the primary and secondary outcome measures.

The taVNS group included 27 males and 20 females, aged (56.5±11.3) years; the s-taVNS group included 26 males and 21 females, aged (58.4±9.7) years, with no significant differences in age or gender between the two groups (all P>0.05). The incidence of moderate to severe pain within 24 hours after surgery was lower in the taVNS group than in the s-taVNS group [14.9% (7/47) v. 38.3% (18/47), P=0.010]. The proportion of patients requiring acetaminophen for rescue analgesia within 24 hours postoperatively was lower in the taVNS group than in the s-taVNS group [8.5% (4/47) vs 23.4% (11/47), P=0.049]. The ISI score on the first postoperative night was lower in the taVNS group than in the s-taVNS group [(3.1±2.7) score vs (5.7±4.3) score, P=0.018].

Perioperative taVNS can effectively reduce the incidence of moderate to severe postoperative pain and improve early postoperative sleep quality in patients undergoing glaucoma surgery under general anesthesia.

The clinical data of 24 patients (25 ears) aged (42.4±13.5) years who underwent unplanned reoperation in the Affiliated People′s Hospital of Fujian University of Traditional Chinese Medicine between January 2018 and May 2025 were retrospectively analyzed, including 12 males and 12 females. The main reasons for the reoperation were tympanic adhesion/granulation hyperplasia (68.0%, 17/25), displacement/dislocation of artificial ossicles (32.0%, 8/25), reperforation of tympanic membrane (32.0%, 8/25), and recurrence of cholesteatoma (28.0%, 7/25). The air-bone conductance differences at each frequency were significantly reduced after the reoperation (P<0.001). The reoperation rate can be reduced by preserving the normal tympanic membrane mucosa, using anti-adhesion materials, repairing the tympanic membrane with the sandwich method, implanting the complete type artificial ossicle with the Ω-shaped base plate, and thoroughly removing the cholesteatoma epithelium, and other preventive and therapeutic strategies.

The 43-year-old female was admitted to the respiratory department of Qingdao Municipal Hospital on May 6, 2025 due to "cough for 1 month". Past physical fitness. Specialist examination showed no thoracic deformity, clear breathing sounds in both lungs, and no dry or wet rales. Carcinoembryonic antigen, squamous cell carcinoma antigen and gastrin-releasing peptide precursor were all negative at admission, and neuron-specific enolase was 21.55 μ g/L. On May 6, 2025, the results of chest enhanced CT showed that massive high-density shadows could be seen in the upper lobe of the left lung, with clear boundaries, and the size of the larger layer was about 112 mm ×80 mm. The density in it was uneven, and the enhanced scan showed uneven enhancement, showing blood vessels running, and some bronchus were compressed and narrowed (Figure A, shown by arrows). On May 12, 2025, the PET/CT results showed that the soft tissue mass in the upper lobe of the left lung was accompanied by fluorodeoxyglucose (FDG) hypermetabolism, and no clear hypermetabolic metastatic lesions were found. In order to confirm the diagnosis and treatment, bronchoscopy was performed on May 7, 2025. Microscopically, new organisms were seen in the bronchial orifice of the upper lobe of the left lung. The new biomass was soft and easy to bleed when touched, so biopsy was performed. The pathological results showed a small round cell tumor in the upper lobe of the left lung, with diffuse nested and acinar arrangement of tumor cells, moderate abnormality, and necrosis (Panel B, hematoxylin-eosin staining ×100). Immunohistochemistry showed that tumor cells were positive for expression of Vimentin, SMA, and CD99 (Panel C), Syn (weakly positive), Ki67 (30% positive), diffuse positive for NKX2.2 (Panel D), and negative for expression of LCA and CD3. Fluorescence in situ hybridization (FISH) assay was positive for t (22q12) (EWSR1), that is, there was an EWSR1 gene-related translocation. Based on the clinical manifestations and pathological findings, primitive neuroectodermal tumor of the lung (PNET) was diagnosed. PNET is an undifferentiated small round cell malignancy originating from primitive neural tube blastocytes. CT of lung PNET mainly showed a large local mass. After enhancement, the tumor showed mild enhancement and uneven enhancement. The pathological characteristics of pulmonary PNET are a large number of primitive small round cells with single morphology and small and dense tumor cells. PNET is highly invasive and has a poor overall prognosis, with a median survival of 3 to 5 years.