Use of slgE/T-IgE in Predicting Systemic Reactions： Retrospective Analysis of 54 Honeybee Venom Allergy Cases in North China

Background： Venom allergy is significantly underestimated in China. Venom-specific IgE may not provide accurate clinical reactions. Our conducted retrospective analysis observes alternative diagnostic considerations in assessing confirmation and severity of honeybee veuom allergy, Methods： Retrospective review of honeybee venom allergy versus nonallergy patients presenled v,ith positive honeybee venom （iI） sIgE results. According to clinically observed reactions caused by a honeybee sting, patients were divided into three groups. Patient residence and exposure types were analyzed. The slgE/T-IgE among allergy and control groups was compared, Results： Gender ratio male：female was 32：22： median age was 39 years （31. 50）. 48% （26/54） of patients live in urban areas. 52% （28/54） in rural areas. Based on bee sting reactions, patients were divided into common localized reactions （32/54）. large localized reactions （7/54）, and systemic reactions （15/54）, In the systemic reaction group, patients presented as Type Ⅱ （6/15）, Type Ⅲ （6/15）. There is significant difference （P 〈 0,001 ） between the three groups in regards to exposure types. In the systemic reaction group. 8.7% （13/15） of patients are beekeepers. A significant difference （P 〈 0.001 ） was observed between allergic and control groups based on slgE/T-lgE results. As well as significant difference observed between the systemic reaction group to the other two reaction groups in regards to slgE/T-IgE results. Six systemic reaction patients presented with large localized reactions before onset of system symptoms 1 month to 1year of being stung. Conclusions： Occupational exposure is the most common cause in honeybee venom allergy induced systemic reactions. The use of sIgE/T-IgE results is a useful diagnostic parameter in determining honeybee venom allergy,

Liver involvement in the drug reaction,eosinophilia,and systemic symptoms syndrome

First described in 1996,the drug reaction,eosinophilia,and systemic symptoms syndrome(DReSS) is considered,along with Stevens-Johnson syndrome and toxic epidermal necrolysis,a severe cutaneous drug reaction. It is characterized by the presence of a maculopapular erythematous skin eruption,fever,lymphadenopathy,influenza-like symptoms,eosinophilia,and visceral involvement such as hepatitis,pneumonitis,myocarditis,pericarditis,nephritis,and colitis. The prognosis of patients with DReSS is related to the severity of visceral involvement. The mortality ranges from approximately 5% to 10%,and death is mainly due to liver failure,which is also the organ most commonly involved in this syndrome. Although it was previously hypothesized in 1994,DReSS syndrome can lead to reactivation of one or more human herpesvirus family members. Now being included as diagnostic criteria in a proposed diagnostic score system,this reactivation can be detected up to 2-3 wk after DReSS syndrome onset. Other causes of mortality in DReSS syndrome include myocardial or pulmonary lesions and hemophagocytosis. We reviewed the literature of previously reported case-series of DReSS and liver involvement,highlighting the pattern of liver damage,the treatment used,and the outcome.

Pulmonary sarcoidosis:A novel sequelae of drug reaction with eosinophilia and systemic symptoms:A case report

BACKGROUND Drug reaction with eosinophilia and systemic symptoms(DRESS)syndrome is an uncommon yet serious adverse drug hypersensitivity reaction with the presentations including rash,fever,lymphadenopathy,and internal organ involvement.Sarcoidosis is a systematic granulomatous disease with unknown etiology.We herein report a case of pulmonary sarcoidosis secondary to allopurinol-induced DRESS.CASE SUMMARY A 37-year-old man with a history of hyperuricemia was treated with allopurinol for three weeks at a total dose of 7000 milligrams before developing symptoms including anorexia,fever,erythematous rash,and elevated transaminase.The patient was diagnosed with DRESS and was treated with prednisone for 6 mo until all the symptoms completely resolved.Three months later,the patient presented again because of a progressively worsening dry cough.His chest computed tomography images showed bilateral lung parenchyma involvement with lymph node enlargement,which was confirmed to be nonnecrotizing granuloma by pathological examination.Based on radiologic and pathological findings,he was diagnosed with sarcoidosis and was restarted on treatment with prednisone,which was continued for another 6 mo.Reexamination of chest imaging revealed complete resolution of parenchymal lung lesions and a significant reduction in the size of the mediastinal and hilar lymph nodes.Following a 6-month follow-up of completion of treatment,the patient's clinical condition remained stable with no clinical evidence of relapse.CONCLUSION This is the first case in which pulmonary sarcoidosis developed as a late complication of allopurinol-induced DRESS.The case indicated that the autoimmune reaction of DRESS may play an important role in the pathogenesis of sarcoidosis.

Reentry Attitude Tracking Control for Hypersonic Vehicle with Reaction Control Systems via Improved Model Predictive Control Approach

This paper studies the reentry attitude tracking control problem for hypersonic vehicles(HSV)equipped with reaction control systems(RCS)and aerodynamic surfaces.The attitude dynamical model of the hypersonic vehicles is established,and the simplified longitudinal and lateral dynamic models are obtained,respectively.Then,the compound control allocation strategy is provided and the model predictive controller is designed for the pitch channel.Furthermore,considering the complicated jet interaction effect of HSV during RCS is working,an improved model predictive control approach is presented by introducing the online parameter estimation of the jet interaction coefficient for dealing with the uncertainty and disturbance.Moreover,considering the strong coupling effect between the yaw channel and roll channel,a coupled model predictive controller is designed by introducing the feedback of sideslip angle into the roll control channel to eliminate the coupling effect.Finally,the comparison simulations using the classical control method,MPC and IMPC approach are given to demonstrate the effectiveness and efficiency of the presented IMPC scheme.

Neurological complications of hematopoietic cell transplantation in children and adults

Hematopoietic cell transplantation（HCT） is widely performed for neoplastic and non-neoplastic diseases. HCT involves intravenous infusion of hematopoietic progenitor cells from human leukocyte antigen（HLA）-matched donor（allogeneic） or from the patient（autologous）. Before HCT, the patient is prepared with high dose chemotherapy and/or radiotherapy to destroy residual malignant cells and to reduce immunologic resistance. After HCT, chemotherapy is used to prevent graft rejection and graft versus host disease（Gv HD）. Neurological complications are related to the type of HCT, underlying disease, toxicity of the conditioning regimens, immunosuppression caused by conditioning regimens, vascular complications generated by thrombocytopenia and/or coagulopathy, Gv HD and inappropriate immune response. In this review, neurological complications are presented according to time of onset after HCT：（1） early complications（in the first month）-related to harvesting of stem cells, during conditioning（drug toxicity, posterior reversible encephalopathy syndrome）, related to pancytopenia,（2） intermediate phase complications（second to sixth month）-central nervous system infections caused by prolonged neutropenia and progressive multifocal leukoencephalopathy due to JC virus,（3） late phase complications（after sixth month）-neurological complications of Gv HD, second neoplasms and relapses of the original disease.

Emergence of spatiotemporal chaos arising from far-field breakup of spiral waves in the plankton ecological systems

It has been reported that the minimal spatially extended phytoplankton-zooplankton system exhibits both temporal regular/chaotic behaviour, and spatiotemporal chaos in a patchy environment. As a further investigation by means of computer simulations and theoretical analysis, in this paper we observe that the spiral waves may exist and the spatiotemporal chaos emerge when the parameters are within the mixed Turing-Hopf bifurcation region, which arises from the far-field breakup of the spiral waves over a large range of diffusion coefficients of phytoplankton and zooplankton. Moreover, the spatiotemporal chaos arising from the far-field breakup of spiral waves does not gradually invade the whole space of that region. Our results are confirmed by nonlinear bifurcation of wave trains, We also discuss ecological implications of these spatially structured patterns.

Global attractors associated with general partly dissipative reaction-diffusion systems in unbounded domains

The asymptotic behaviour of solutions for general partly dissipative reaction-diffusion systems in Rn is studied. The asymptotic compactness of the solutions and then the existence of the global attractor are proved in L2(Rn )× L2(Rn ) .

Global Bounded Solutions for Reaction-diffusion Systems with a Full Matrix of Diffusion Coefficients and a Balance Law

This paper deals with an initial boundary value problem for the strongly coupledreaction-diffusion systems with a full matrix of diffusion coefficients. The global existence ofsolutions is proved by using the techniques based on invariant regions, Lyapunov functionalmethods, and local Lp prior estimates independent of time.

Critical Fujita Exponents for Localized Reaction Diffusion Systems

In this paper, we prove the existence of cirtical Fujita exponents for a class of localized reaction diffusion systems.

Early diagnosis and monitoring of active HCMV infection in children with systemic lupus erythematosus

Objective To investigate the prevalence and features of active human cytomegalovirus (HCMV) infection in children with systemic lupus erythematosus (SLE) and evaluate the diagnostic value of the HCMV using antigenemia assay, serum polymerase chain reaction (PCR) and serology test. Methods Twenty-one SLE children undergoing immunosuppressive therapy were enrolled in this study. Immunofluorescence assay, PCR and serology tests were used to determine HCMV pp65 and p72 antigens in leukocytes, HCMV DNA in sera, and HCMV specific IgM and IgG antibodies, respectively. As a control group, twenty-one immunocompetent children with skeletal malformation were involved in this study. Statistical analysis was performed using Chi-square test or Fisher's exact test (Systat, USA), P values less than 0.05 were considered significant.Results Active HCMV infection was diagnosed in 28.6% (6/21) of SLE patients, with none in the control group; the difference between the two groups was significant (P=0.027). Two out of 6 SLE patients developed active HCMV infection before immunosuppressive therapy and the remaining 4 patients developed SLE after immunosuppressive therapy. Among the 21 SLE children, HCMV pp65 antigenemia was detected in 5 patients, p72 antigenemia in 3 patients, serum HCMV DNA in 9 patients, serum HCMV-specific IgM in 2 patients, and IgG in 19 patients. The sensitivity and specificity for diagnosis of active HCMV infection were 83.3% and 100%, respectively for pp65 antigenemia; 50% and 100% for p72 antigenemia; 100% and 80% for serum PCR; 33.3% and 100% for HCMV IgM serology; 50% and 100% for HCMV IgG serology. Conclusions Compared with the control group, active HCMV infection is much more frequent in SLE children, and can occur before treatment with immunosuppressive agents, but most often occur after immunosuppressive therapy. In comparison with the other techniques used in this study, the pp65 antigenemia assay seems to be a better method for the early diagnosis and monitoring of active HCMV infection in children with SLE.

Drug Reaction with Eosinophilia and Systemic Symptoms： Retrospective Analysis of 104 Cases over One Decade

Background： Drug reaction with eosinophilia and systemic symptoms （DRESS） is a severe, life-threatening disorder caused by drugs. In the present study, we tried to explore the types of DRESS-inducing drugs, incubation period, features of skin rashes, accompanying visceral damage, and effectiveness of glucocorticoid therapy so as to inform clinical practice. Methods： Patients diagnosed with a drug-induced rash, dermatitis, and DRESS admitted to our hospital from January 2006 to December 2015 were included in the study. The diagnosis followed the criteria and scoring system set by the European Registry of Severe Cutaneous Adverse Reactions. Statistical analyses were carried out using SPSS version 17.0 （IBM, Armonk, NY, USA）, and a value ofP 〈 0.05 was considered statistically significant. Results： Among 104 patients, 38 were male and 66 female （aged 18-83 years）. The latent period was 13 （interquartile range [IQR]： 10-17） days. The most common allergy-inducing drugs were antibiotics （n = 37, 35.6%）, followed by antiepileptic drugs and traditional Chinese medicines （TCMs）. Eighty-two cases （78.8%） had rash with area 〉50% body surface area （BSA）. Liver damage occurred in 90% of cases. Patients were divided into oral antihistamine group and glucocorticoid/immunosuppressive agent/intravenous immunoglobulin （IVIG） group. Sex, age, incubation period, duration of hospital stay, and the number of patients with body temperature 〉38.5℃ were not significantly different between the two groups. However, the number of patients meeting the criteria of＂definite＂ and ＂probable＂ （X2 =5.852, P = 0.016）, with an eosinophilic granulocyte count of〉1.5 x10^9/L 0,2 7.129, P = 0.008）, and with rash area of〉50% BSA （X2 = 4.750, P = 0.029）, was significantly different. Conclusions： Antibiotics were associated with allergic reactions, but TCMs also had an important role. Allergy resulting from repeat use of the same drug was more severe with a shorter incubation period. The most typical rash was widespread erythematous papules. Liver damage accounted for 〉90% of cases.

Awareness and attitudes of healthcare professionals in Wuhan,China to the reporting of adverse drug reactions

Background A voluntary procedure for reporting adverse drug reactions (ADRs) was formally put in place in 1989. However,only a small proportion of ADR reports are actually forwarded to the national monitoring center. To identify the reasons for underreporting,the authors investigated the awareness and attitudes of healthcare professionals (doctors,nurses,and administrators) toward the ADR system in China. In addition,the authors sought to formulate approaches to improve the current ADR reporting system.Methods Structured interviews were carried out in 16 hospitals selected from 27 municipal hospitals in Wuhan,Hubei Province,China. A questionnaire survey of a stratified random sample of approximately 15% of healthcare professionals in each selected hospital was conducted during February to March 2003.Results The response rate of this survey was 85%. One thousand six hundred and fifty-three questionnaires were used in the final analysis. Only 2.7% of the healthcare professionals had a correct understanding to the definition of ADR. Eighty-nine point two percent of the healthcare professionals had encountered ADRs. Ninety-four percent of them were aware of the need to report these to the ADR monitoring center. However,only 28.5% of doctors,22.8% of nurses,and 29.7% of administrators actually submitted a report. For the most part,they reported ADRs to the hospital pharmacy (66.0%),to other departments in the hospital (72.5%),and to the pharmaceutical industry (23.0%),rather than to the national monitoring center (2.9%) or regional monitoring center (9.5%). Severe or rare ADRs and ADRs to new products were generally perceived to be significant enough to report. Sixty-two point one percent of the healthcare professionals had encountered ADRs,yet not reported them to anybody. The major reasons for not reporting included no knowledge of the reporting procedure (71.4%),unavailability of the reporting center mailing address (67.9%),unavailability of the ADR report form (60.4%),lack of knowledge of the existence of a national ADR reporting system (52.2%),and belief that the ADR in question was already well known (44.1%). Conclusions Healthcare professionals in Wuhan,China have little basic knowledge of ADR and of the voluntary reporting system. The main reasons for underreporting were lack of basic knowledge about ADRs and the voluntary reporting procedure. Education and training of healthcare professionals is needed to improve the current ADR reporting system.

RESILIENCE 2.0： COMPUTER-AIDED DISASTER MANAGEMENT

Many factors （larger population, more dependency on technology, more human-caused interference in the natural systems and equilibria, climate changes,... ） contribute to the seemingly growing number and severity of disasters. Additional exaggeration is generated by public media. As a consequence Disaster Prevention and Disaster Management must be given increased attention. The ultimate goal of Disaster Management is resilience of the affected system and thus the adequate and acceptable survival of the affected population. We discuss system behavior in the case of an assault or disturbance： from being fragile （loss of their functionality due to the assault） to being resilient （having the capacity ... of bouncing back to dynamic stability after a disturbance）, or even antifragile （being able to ＂learn＂ so as to improve disaster resilience）. Resilience 2. 0 identifies a new paradigm： modem Information and Communication Technologies （ICT） are employed as a basis for enabling and improving resilience of a system. ICT provide the basis for sufficient preparation before an assault, for quick recognition of, and for effective, efficient reactions to disasters. Only the coordinated intra- and interphase deployment of ICT promises sufficient success and can bring resilience to currently as yet fragile systems. We discuss stressors （time and performance pressure, physical and psychological stress on personnel） and problems due to damaged ICT-platforms and communication infrastructure. The basic message is that computer-aided Disaster Management is able to offers a new level of reactivity： Resilience 2.0.

Simultaneous H_2/H_∞ Stabilization for Chemical Reaction Systems Based on Orthogonal Complement Space

This paper presents a simultaneous H2/H∞ stabilization problem for the chemical reaction systems which can be modeled as a finite collection of subsystems. A single dynamic output feedback controller which simultaneously stabilizes the multiple subsystems and captures the mixed H2/H∞ control performance is designed. To ensure that the stability condition, the H2 characterization and the H∞ characterization can be enforced within a unified matrix inequality framework, a novel technique based on orthogonal complement space is developed. Within such a framework, the controller gain is parameterized by the introduction of a common free positive definite matrix, which is independent of the multiple Lyapunov matrices. An iterative linear matrix inequality （ILMI） algorithm using Matlab Yalmip toolbox is established to deal with the proposed framework. Simulation results of a typical chemical reaction system are exploited to show the validity of the proposed methodology.

Simultaneous Identification of Two Parameters on the Reaction Diffusion System from Discrete Measurement Data

This article deals with an inverse problem of reconstructing two time independent coefficients in the reaction diffusion system from the final time space discretized measurement using the optimization method with the help of the smooth interpolation technique.The main objective of the article is to analyse the asymptotic behavior of the solution of the inverse problem for the linearly coupled reaction diffusion system with respect to the homogeneous Dirichlet boundary condition.

CHEBYSHEV METHODS WITH DISCRETE NOISE:THE T-ROCK METHODS

Stabilized or Chebyshev explicit methods have been widely used in the past to solve stiff ordinary differential equations. Making use of special properties of Chebyshev-like polynomials, these methods have favorable stability properties compared to standard explicit methods while remaining explicit. A new class of such methods, called ROCK, introduced in [Numer. Math., 90, 1-18, 2001] has recently been extended to stiff stochastic differential equations under the name S-ROCK [C. R. Acad. Sci. Paris, 345（10）, 2007 and Commun. Math. Sci, 6（4）, 2008]. In this paper we discuss the extension of the S-ROCK methods to systems with discrete noise and propose a new class of methods for such problems, the τ-ROCK methods. One motivation for such methods is the simulation of multi-scale or stiff chemical kinetic systems and such systems are the focus of this paper, but our new methods could potentially be interesting for other stiff systems with discrete noise. Two versions of the τ-ROCK methods are discussed and their stability behavior is analyzed on a test problem. Compared to the τ-leaping method, a significant speed-up can be achieved for some stiff kinetic systems. The behavior of the proposed methods are tested on several numerical experiments.

Analysis of survival probability based on superasymmetric reaction systems

The survival probability of an excited compound nucleus was studied using two different approaches of the washing out of shell effects with excitation energy based on a superasymmetric reaction system.The estimated evaporation residue cross sections based on the two different methods are compared with the available experimental data.Both methods are in agreement with the experimental data to a certain extent for some specific reactions and emission channels.

Parameter identification through mode isolation for reaction-diffusion systems on arbitrary geometries

We present a computational framework for isolating spatial patterns arising in the steady states of reaction-diffusion systems. Such systems have been used to model many nat- ural phenomena in areas such as developmental and cancer biology, cell motility and material science. In many of these applications, often one is interested in identifying parameters which will lead to a particular pattern for a given reaction-diffusion model. To attempt to answer this, we compute eigenpairs of the Laplacian on a variety of domains and use linear stability analysis to determine parameter values for the system that will lead to spatially inhomogeneous steady states whose patterns correspond to particular eigenfunctions. This method has previously been used on domains and surfaces where the eigenvalues and eigenfunctions are found analytically in closed form. Our contribution to this methodology is that we numerically compute eigenpairs on arbitrary domains and surfaces. Here we present examples and demonstrate that mode isolation is straightforward especially for low eigenvalues. Additionally, we show that in some cases the inhomogeneous steady state can be a linear combination of eigenfunctions. Finally,we show an example suggesting that pattern formation is robust on similar surfaces in cases that the surface either has or does not have a boundary.

A critical transition rule for broadening exponent of fluctuation and its effect on dissipation in chemical reaction-heat conduction coupling systems

A stochastic model of chemical reaction-heat conduction-diffusion for a one-dimensional gaseous system under Dirichlet or zero-fluxes boundary conditions is proposed in this paper. Based on this model,we extend the theory of the broadening exponent of critical fluctuations to cover the chemical reaction-heat conduction coupling systems as an asymptotic property of the corresponding Markovian master equation (ME),and establish a valid stochastic thermodynamics for such systems. As an illustration,the non-isothermal and inhomogeneous Schl-gl model is explicitly studied. Through an order analysis of the contributions from both the drift and diffusion to the evolution of the probability distribution in the corresponding Fokker-Planck equation(FPE) in the approach to bifurcation,we have identified the critical transition rule for the broadening exponent of the fluctuations due to the coupling between chemical reaction and heat conduction. It turns out that the dissipation induced by the critical fluctuations reaches a deterministic level,leading to a thermodynamic effect on the nonequilibrium physico-chemical processes.