The pathogenesis of inflammatory bowel disease (IBD) is complex and largely unknown. Until recently, research has focused on the study of protein regulators in inflammation to reveal the cellular and molecular network...The pathogenesis of inflammatory bowel disease (IBD) is complex and largely unknown. Until recently, research has focused on the study of protein regulators in inflammation to reveal the cellular and molecular networks in the pathogenesis of IBD. However, in the last few years, new and promising insights have been generated from studies describing an association between an altered expression of a specific class of non-coding RNAs, called microRNAs (miRs or miRNAs) and IBD. The short (approximately 22 nucleotides), endogenous, single-stranded RNAs are evolutionary conserved inanimals and plants, and regulate specific target mRNAs at the post-transcriptional level. MiRNAs are involved in several biological processes, including development, cell differentiation, proliferation and apoptosis. Furthermore, it is estimated that miRNAs may be responsible for regulating the expression of nearly one-third of the genes in the human genome. Thus, miRNA deregulation often results in an impaired cellular function, and a disturbance of downstream gene regulation and signaling cascades, suggesting their implication in disease etiology. Despite the identification of more than 1900 mature human miRNAs, very little is known about their biological functions and functional targets. Recent studies have identified dysregulated miRNAs in tissue samples of IBD patients and have demonstrated similar differences in circulating miRNAs in the serum of IBD patients. Thus, there is great promise that miRNAs will aid in the early diagnosis of IBD, and in the development of personalized therapies. Here, we provide a short review of the current state-of-the-art of miRNAs in IBD pathogenesis, diagnostics and therapeutics.展开更多
AIM： To assess the actigraphy, an ambulatory and continuous monitoring of wrist motor activity fitted to study sleep/wake patterns in hepatic encephalopathy （HE）. METHODS： Twenty-five cirrhotic patients （17 M, 8 ...AIM： To assess the actigraphy, an ambulatory and continuous monitoring of wrist motor activity fitted to study sleep/wake patterns in hepatic encephalopathy （HE）. METHODS： Twenty-five cirrhotic patients （17 M, 8 F, mean age 56± 11 years, 24/25 alcoholic, Child-Pugh A, B, C： 2, 6, 17） were included. The patients were classified into 3 groups： stage 0 group （n = 12）, stage 1-2 group （n = 6）, and stage 3-4 group （n = 7） of encephalopathy. Over three consecutive days, patients had clinical evaluation 3 times a day with psychometric test, venous ammoniemia, flash visually evoked potentials （VEP）, electroencephalogram and continuous actigraphic monitoring for 3 d, providing 5 parameters： mesor, amplitude, acrophase, mean duration of activity （MDAI） and inactivity （MDII） intervals. RESULTS： Serum ammonia and VEP did not differ among the 3 groups. Electroencephalography mean dominant frequency （MDF） correlated significantly with clinical stages of HE （r=0.65, P=0.003）. The best correlation with HE stage was provided by actigraphy especially with MDAI （r= 0.7, P〈10^-4） and mesor （r= 0.65, P〈 10^-4）. MDAI correlated significantly with MDF （r= 0.62, 0.004） and was significantly shorter in case of HE compared to patients without HE （stage 0： 5.33± 1.6 min; stage 1-2：3.28±1.4 min; stage 3-4：2.52±1.1 min; P〈0.05）. Using a threshold of MDAI of less than 4.9 min, sensitivity, specificity, positive predictive value, negative predictive value for HE diagnosis were 85%, 67%, 73% and 80%, respectively. CONCLUSION： Actigraphy may be an objective method to identify HE, especially for early HE detection. Motor activity at the wrist correlates well with clinical stages of HE. MDAI and mesor are the most relevant parameters.展开更多
Estimates of people suffering from overweight (one billion) and obesity (300 million) are increasing. The accumulation of triglycerides in the liver, in the absence of excess alcohol intake, has been described in the ...Estimates of people suffering from overweight (one billion) and obesity (300 million) are increasing. The accumulation of triglycerides in the liver, in the absence of excess alcohol intake, has been described in the early sixties. It was not until 1980, however, that Ludwig et al named this condition nonalcoholic steatohepatitis (NASH). Subsequently, nonalcoholic fatty liver disease (NAFLD) has been used as a general name for conditions ranging from simple steatosis through steatohepatitis to end-stage liver disease (cirrhosis). Many studies have demonstrated the significant correlation with obesity and insulin resistance. Other studies have revealed a signifi- cant correlation between hepatic steatosis, cardiovascu- lar disease and increased intima-media thickness. WHO estimated that at least two million patients will develop cirrhosis due to hepatic steatosis in the years to come. Longitudinal cohort studies have demonstrated that those patients with cirrhosis have a similar risk to devel- op hepatocellular carcinoma as those with other causes of cirrhosis. Taken all together, NAFLD has become the third most important indication for liver transplantation. There- fore, training programmes in internal medicine, gastroen- terology and hepatology should stress the importance of diagnosing this entity and treat properly those at risk for developing complications of portal hypertension and con- comittant cardiovascular disease. This review will focus on the clinical characteristics, pathophysiology, imaging tech- niques and the readily available therapeutic options.展开更多
OBJECTIVE To enhance the understanding of Castleman’s disease (CD), and to improve its diagnosis and management. METHODS Clinical features and related information on diagnosis and treatment of 14 cases of CD were ret...OBJECTIVE To enhance the understanding of Castleman’s disease (CD), and to improve its diagnosis and management. METHODS Clinical features and related information on diagnosis and treatment of 14 cases of CD were retrospectively analyzed and the literature reviewed. RESULTS Based on the clinical classification, localized CD was found in 8 of the 14 cases. Both the results of lymph node biopsy and histopathology indicated they were a hyaline-vascular type. The multicentric type CD was detected in 6 cases, among which 4 were plasma cell type and 2 mixed type based on histopathologic examination. There were a variety of clinical situa-tions in the 14 cases, with a lack of specificity. They were previously misdiag-nosed as other diseases, and final diagnosis depended on a histopathologic examination. The 8 patients with localized CD underwent excision, without recurrence up to now. The 6 patients with multicentric-type CD were treated with glucocorticoids or combined chemotherapy, and all achieved remission. CONCLUSIONS CD has complicated clinical manifestations and is difficult to diagnose. Lymph node biopsy is important for early diagnosis. An optimal curative effect can be achieved with a suitable therapeutic option, based on histopathology and clinical classification.展开更多
Objective： We studied the diagnosis and therapy of primary lung diffuse large B cell lymphoma （DLBCL）. Methods： Analysis the clinical manifestations, pathologic character and immunohistochemical character of one l...Objective： We studied the diagnosis and therapy of primary lung diffuse large B cell lymphoma （DLBCL）. Methods： Analysis the clinical manifestations, pathologic character and immunohistochemical character of one lung diffuse B cell lymphoma patent. Results： In visual observation, it＇s a gray irregular fobulated mass, section was gray, fish-like, and number of necrotic foci. Observed under the microscope, subepithelial respiratory center oocyte-like cells diffuse proliferative, infiltration in lung tissue. Immunohistochemistry： CD20 （＋）, CD79a （＋）, CD3 （-）, CD45RO （-）, PCK （-）. Conclusion： Diffuse large B cell lymphoma is the most common subtype in non-Hodgkin lymphoma, but the primary lung diffuse large B cell lymphoma is rare. This disease is lack of typical clinical manifestations, so easily misdiagnosed. The diagnosis of diffuse large B cell lymphoma should be based on pathology and immunohistochemistry.展开更多
Objective： To study clinical characteristics of non-Hodgkin＇s lymphoma （NHL） in order to diagnose and treat early and improve prognosis. Methods： 112 cases with NHL were pathologically diagnosed and treated in 19...Objective： To study clinical characteristics of non-Hodgkin＇s lymphoma （NHL） in order to diagnose and treat early and improve prognosis. Methods： 112 cases with NHL were pathologically diagnosed and treated in 1992-2005. Results： Among all cases, 30 were not treated previously, 79 were involved in peripheral lymph nodes, 55 deep lymph nodes, 18 Waldeyer＇s ring, 25 respiratory system, 26 digestive system, 26 spleen, 13 bone, 13 skin and subcutaneous, 4 urinogenital system, 13 other sites. Among 30 previously untreated patients, there were 4 staged 1, 3 IE1 5 Ⅱ, 1 ⅡE, 9 Ⅲ, 1 Ⅲs and 7 IV. Among 82 patients with prior treatment, 29 were involved in lymph nodes only, 53 involved in different organs and tissues. In our series, there were 38 cases and 74 cases belonged to subtype A and subtype B respectively. Conclusion： The enlargement of peripheral lymph nodes is main clinical characteristic in NHL, but lesions also involve different organs and tissues. The diagnosis of NHL depends upon pathological examination.展开更多
Objective: To investigate the clinical features, diagnostic methods, and treatment choice of tumor of the papilla of Vater. Methods: The clinical data of 25 patients with tumor of the papilla of Vater treated by local...Objective: To investigate the clinical features, diagnostic methods, and treatment choice of tumor of the papilla of Vater. Methods: The clinical data of 25 patients with tumor of the papilla of Vater treated by local resection in our hospital from December 1983 to May 2006 were retrospectively analyzed. Results: The morbidities of abdominal pain, jaundice and recurrent cholangitis were 84%, 80% and 48%, respectively. The accordant rate for preoperative duodenoscopic biopsy and post-operative pathological diagnosis was 80%. Intraoperative frozen section examination accurately predicted the final pathological results in all the patients. The post-operative complication rate was 20% and the operative mortality rate was 4%. The 5-year survival rates of local resection for benign tumors and malignant tumors were 75% and 28.5%, respectively. Conclusion: Abdominal pain, jaundice and recurrent cholangitis are the main symptoms and signs of tumor of the papilla of Vater. Duodenoscopy is the principal preoperative diagnostic method and intraoperative frozen section examination is reliable in assessing the operative specimens. Selective local resection is an effective treatment option for tumor of the papilla of Vater.展开更多
Hepatic encephalopathy(HE)is a reversible syndrome of impaired brain function occurring in patients with advanced liver diseases.The precise pathophysiology of HE is still under discussion;the leading hypothesis focus...Hepatic encephalopathy(HE)is a reversible syndrome of impaired brain function occurring in patients with advanced liver diseases.The precise pathophysiology of HE is still under discussion;the leading hypothesis focus on the role of neurotoxins,impaired neurotransmission due to metabolic changes in liver failure,changes in brain energy metabolism,systemic inflammatory response and alterations of the blood brain barrier.HE produces a wide spectrum of nonspecific neurological and psychiatric manifestations.Minimal HE is diagnosed by abnormal psychometric tests.Clinically overt HE includes personality changes,alterations in consciousness progressive disorientation in time and space,somnolence,stupor and,finally,coma.Except for clinical studies,no specific tests are required for diagnosis.HE is classified according to the underlying disease,the severity of manifestations,its time course and the existence of precipitating factors.Treatment of overt HE includes supportive therapies,treatment of precipitating factors,lactulose and/or rifaximin.Routine treatment for minimal HE is only recommended for selected patients.展开更多
Background： The specialty of allergy developed quickly in western countries because of the rapid increase of allergic diseases, whereas it developed relatively slowly in China. The prevalence of allergen sensitizatio...Background： The specialty of allergy developed quickly in western countries because of the rapid increase of allergic diseases, whereas it developed relatively slowly in China. The prevalence of allergen sensitization and allergic diseases in Zhejiang Province of China is high and improving the medical services for these diseases is critically needed. Objective： To investigate the working status of the diagnosis and treatment of allergic diseases, including doctor resources, diagnostic methods, and allergen-specific immunotherapy in patients of Zhejiang Province, and to provide instructions for the strategic development of subspecialties of allergic diseases. Methods： First we defined the doctors who treat allergic diseases, and designed a comprehensive questionnaire to collect personal and hospital information for these doctors. The questionnaires were distributed to hospitals with different ranks and from different areas in the province. The general condition of doctor＇s resources, carryout of diagnostic methods, and allergen-specific immunotherapy were described and variations in the different specialties, hospitals, and areas were further analyzed. Results： Doctors in their thirties with bachelor＇s degrees were the mainstream for diagnosing and treating allergic diseases. The main specialties of the doctor resources were the specialties of Ear, Nose and Throat（ENT）, Respirology, Pediatrics, and Dermatology. The Pediatrics specialty had a more reasonable infrastructure of doctor resources with more young doctors working in this subspecialty. The development of allergy subspecialty varied within hospitals at different levels or from different areas. The carryout of the skin prick test（SPT）, serum specific Ig E（ss Ig E）, and subcutaneous immunotherapy（SCIT） was best performed in provincial hospitals, while sublingual immunotherapy（SLIT） was prescribed most commonly in municipal hospitals. The performance of SPT and ss Ig E in Hangzhou, Jiaxing, and Wenzhou areas was much better than that in other places. The performance of SCIT and SLIT was best in Wenzhou. Conclusions： Our survey revealed a very initial and unbalanced development for the allergy subspecialty in Zhejiang Province. Doctor resources for allergic diseases were mainly from the specialties of ENT, Respirology, and Pediatrics, and the performance of diagnosis and treatment was mainly focused on provincial and municipal hospitals. Continuous education of allergies could be extended to primary healthcare centers and more efforts should be directed to those areas with poor medical resources.展开更多
基金Supported by Grants from Fonden til Lgevidenskabens Fremme(the AP Mller Foundation)the Family Erichsen Memorial Foundation+2 种基金the Lundbeck Foundationthe Axel Muusfeldts Foundationthe Foundation of Aase and Ejnar Danielsen
文摘The pathogenesis of inflammatory bowel disease (IBD) is complex and largely unknown. Until recently, research has focused on the study of protein regulators in inflammation to reveal the cellular and molecular networks in the pathogenesis of IBD. However, in the last few years, new and promising insights have been generated from studies describing an association between an altered expression of a specific class of non-coding RNAs, called microRNAs (miRs or miRNAs) and IBD. The short (approximately 22 nucleotides), endogenous, single-stranded RNAs are evolutionary conserved inanimals and plants, and regulate specific target mRNAs at the post-transcriptional level. MiRNAs are involved in several biological processes, including development, cell differentiation, proliferation and apoptosis. Furthermore, it is estimated that miRNAs may be responsible for regulating the expression of nearly one-third of the genes in the human genome. Thus, miRNA deregulation often results in an impaired cellular function, and a disturbance of downstream gene regulation and signaling cascades, suggesting their implication in disease etiology. Despite the identification of more than 1900 mature human miRNAs, very little is known about their biological functions and functional targets. Recent studies have identified dysregulated miRNAs in tissue samples of IBD patients and have demonstrated similar differences in circulating miRNAs in the serum of IBD patients. Thus, there is great promise that miRNAs will aid in the early diagnosis of IBD, and in the development of personalized therapies. Here, we provide a short review of the current state-of-the-art of miRNAs in IBD pathogenesis, diagnostics and therapeutics.
文摘AIM： To assess the actigraphy, an ambulatory and continuous monitoring of wrist motor activity fitted to study sleep/wake patterns in hepatic encephalopathy （HE）. METHODS： Twenty-five cirrhotic patients （17 M, 8 F, mean age 56± 11 years, 24/25 alcoholic, Child-Pugh A, B, C： 2, 6, 17） were included. The patients were classified into 3 groups： stage 0 group （n = 12）, stage 1-2 group （n = 6）, and stage 3-4 group （n = 7） of encephalopathy. Over three consecutive days, patients had clinical evaluation 3 times a day with psychometric test, venous ammoniemia, flash visually evoked potentials （VEP）, electroencephalogram and continuous actigraphic monitoring for 3 d, providing 5 parameters： mesor, amplitude, acrophase, mean duration of activity （MDAI） and inactivity （MDII） intervals. RESULTS： Serum ammonia and VEP did not differ among the 3 groups. Electroencephalography mean dominant frequency （MDF） correlated significantly with clinical stages of HE （r=0.65, P=0.003）. The best correlation with HE stage was provided by actigraphy especially with MDAI （r= 0.7, P〈10^-4） and mesor （r= 0.65, P〈 10^-4）. MDAI correlated significantly with MDF （r= 0.62, 0.004） and was significantly shorter in case of HE compared to patients without HE （stage 0： 5.33± 1.6 min; stage 1-2：3.28±1.4 min; stage 3-4：2.52±1.1 min; P〈0.05）. Using a threshold of MDAI of less than 4.9 min, sensitivity, specificity, positive predictive value, negative predictive value for HE diagnosis were 85%, 67%, 73% and 80%, respectively. CONCLUSION： Actigraphy may be an objective method to identify HE, especially for early HE detection. Motor activity at the wrist correlates well with clinical stages of HE. MDAI and mesor are the most relevant parameters.
文摘Estimates of people suffering from overweight (one billion) and obesity (300 million) are increasing. The accumulation of triglycerides in the liver, in the absence of excess alcohol intake, has been described in the early sixties. It was not until 1980, however, that Ludwig et al named this condition nonalcoholic steatohepatitis (NASH). Subsequently, nonalcoholic fatty liver disease (NAFLD) has been used as a general name for conditions ranging from simple steatosis through steatohepatitis to end-stage liver disease (cirrhosis). Many studies have demonstrated the significant correlation with obesity and insulin resistance. Other studies have revealed a signifi- cant correlation between hepatic steatosis, cardiovascu- lar disease and increased intima-media thickness. WHO estimated that at least two million patients will develop cirrhosis due to hepatic steatosis in the years to come. Longitudinal cohort studies have demonstrated that those patients with cirrhosis have a similar risk to devel- op hepatocellular carcinoma as those with other causes of cirrhosis. Taken all together, NAFLD has become the third most important indication for liver transplantation. There- fore, training programmes in internal medicine, gastroen- terology and hepatology should stress the importance of diagnosing this entity and treat properly those at risk for developing complications of portal hypertension and con- comittant cardiovascular disease. This review will focus on the clinical characteristics, pathophysiology, imaging tech- niques and the readily available therapeutic options.
文摘OBJECTIVE To enhance the understanding of Castleman’s disease (CD), and to improve its diagnosis and management. METHODS Clinical features and related information on diagnosis and treatment of 14 cases of CD were retrospectively analyzed and the literature reviewed. RESULTS Based on the clinical classification, localized CD was found in 8 of the 14 cases. Both the results of lymph node biopsy and histopathology indicated they were a hyaline-vascular type. The multicentric type CD was detected in 6 cases, among which 4 were plasma cell type and 2 mixed type based on histopathologic examination. There were a variety of clinical situa-tions in the 14 cases, with a lack of specificity. They were previously misdiag-nosed as other diseases, and final diagnosis depended on a histopathologic examination. The 8 patients with localized CD underwent excision, without recurrence up to now. The 6 patients with multicentric-type CD were treated with glucocorticoids or combined chemotherapy, and all achieved remission. CONCLUSIONS CD has complicated clinical manifestations and is difficult to diagnose. Lymph node biopsy is important for early diagnosis. An optimal curative effect can be achieved with a suitable therapeutic option, based on histopathology and clinical classification.
文摘Objective： We studied the diagnosis and therapy of primary lung diffuse large B cell lymphoma （DLBCL）. Methods： Analysis the clinical manifestations, pathologic character and immunohistochemical character of one lung diffuse B cell lymphoma patent. Results： In visual observation, it＇s a gray irregular fobulated mass, section was gray, fish-like, and number of necrotic foci. Observed under the microscope, subepithelial respiratory center oocyte-like cells diffuse proliferative, infiltration in lung tissue. Immunohistochemistry： CD20 （＋）, CD79a （＋）, CD3 （-）, CD45RO （-）, PCK （-）. Conclusion： Diffuse large B cell lymphoma is the most common subtype in non-Hodgkin lymphoma, but the primary lung diffuse large B cell lymphoma is rare. This disease is lack of typical clinical manifestations, so easily misdiagnosed. The diagnosis of diffuse large B cell lymphoma should be based on pathology and immunohistochemistry.
文摘Objective： To study clinical characteristics of non-Hodgkin＇s lymphoma （NHL） in order to diagnose and treat early and improve prognosis. Methods： 112 cases with NHL were pathologically diagnosed and treated in 1992-2005. Results： Among all cases, 30 were not treated previously, 79 were involved in peripheral lymph nodes, 55 deep lymph nodes, 18 Waldeyer＇s ring, 25 respiratory system, 26 digestive system, 26 spleen, 13 bone, 13 skin and subcutaneous, 4 urinogenital system, 13 other sites. Among 30 previously untreated patients, there were 4 staged 1, 3 IE1 5 Ⅱ, 1 ⅡE, 9 Ⅲ, 1 Ⅲs and 7 IV. Among 82 patients with prior treatment, 29 were involved in lymph nodes only, 53 involved in different organs and tissues. In our series, there were 38 cases and 74 cases belonged to subtype A and subtype B respectively. Conclusion： The enlargement of peripheral lymph nodes is main clinical characteristic in NHL, but lesions also involve different organs and tissues. The diagnosis of NHL depends upon pathological examination.
文摘Objective: To investigate the clinical features, diagnostic methods, and treatment choice of tumor of the papilla of Vater. Methods: The clinical data of 25 patients with tumor of the papilla of Vater treated by local resection in our hospital from December 1983 to May 2006 were retrospectively analyzed. Results: The morbidities of abdominal pain, jaundice and recurrent cholangitis were 84%, 80% and 48%, respectively. The accordant rate for preoperative duodenoscopic biopsy and post-operative pathological diagnosis was 80%. Intraoperative frozen section examination accurately predicted the final pathological results in all the patients. The post-operative complication rate was 20% and the operative mortality rate was 4%. The 5-year survival rates of local resection for benign tumors and malignant tumors were 75% and 28.5%, respectively. Conclusion: Abdominal pain, jaundice and recurrent cholangitis are the main symptoms and signs of tumor of the papilla of Vater. Duodenoscopy is the principal preoperative diagnostic method and intraoperative frozen section examination is reliable in assessing the operative specimens. Selective local resection is an effective treatment option for tumor of the papilla of Vater.
文摘Hepatic encephalopathy(HE)is a reversible syndrome of impaired brain function occurring in patients with advanced liver diseases.The precise pathophysiology of HE is still under discussion;the leading hypothesis focus on the role of neurotoxins,impaired neurotransmission due to metabolic changes in liver failure,changes in brain energy metabolism,systemic inflammatory response and alterations of the blood brain barrier.HE produces a wide spectrum of nonspecific neurological and psychiatric manifestations.Minimal HE is diagnosed by abnormal psychometric tests.Clinically overt HE includes personality changes,alterations in consciousness progressive disorientation in time and space,somnolence,stupor and,finally,coma.Except for clinical studies,no specific tests are required for diagnosis.HE is classified according to the underlying disease,the severity of manifestations,its time course and the existence of precipitating factors.Treatment of overt HE includes supportive therapies,treatment of precipitating factors,lactulose and/or rifaximin.Routine treatment for minimal HE is only recommended for selected patients.
基金Project supported by the National Natural Science Foundation of China(No.30600266)the Zhejiang Provincial Science and Technology Project(No.2011C37073)+2 种基金the Zhejiang Provincial Natural Science Foundation(No.LQ12H16012)the National Key Clinical Project of Allergy of Chinathe National Key Clinical Specialist Construction Programs of China
文摘Background： The specialty of allergy developed quickly in western countries because of the rapid increase of allergic diseases, whereas it developed relatively slowly in China. The prevalence of allergen sensitization and allergic diseases in Zhejiang Province of China is high and improving the medical services for these diseases is critically needed. Objective： To investigate the working status of the diagnosis and treatment of allergic diseases, including doctor resources, diagnostic methods, and allergen-specific immunotherapy in patients of Zhejiang Province, and to provide instructions for the strategic development of subspecialties of allergic diseases. Methods： First we defined the doctors who treat allergic diseases, and designed a comprehensive questionnaire to collect personal and hospital information for these doctors. The questionnaires were distributed to hospitals with different ranks and from different areas in the province. The general condition of doctor＇s resources, carryout of diagnostic methods, and allergen-specific immunotherapy were described and variations in the different specialties, hospitals, and areas were further analyzed. Results： Doctors in their thirties with bachelor＇s degrees were the mainstream for diagnosing and treating allergic diseases. The main specialties of the doctor resources were the specialties of Ear, Nose and Throat（ENT）, Respirology, Pediatrics, and Dermatology. The Pediatrics specialty had a more reasonable infrastructure of doctor resources with more young doctors working in this subspecialty. The development of allergy subspecialty varied within hospitals at different levels or from different areas. The carryout of the skin prick test（SPT）, serum specific Ig E（ss Ig E）, and subcutaneous immunotherapy（SCIT） was best performed in provincial hospitals, while sublingual immunotherapy（SLIT） was prescribed most commonly in municipal hospitals. The performance of SPT and ss Ig E in Hangzhou, Jiaxing, and Wenzhou areas was much better than that in other places. The performance of SCIT and SLIT was best in Wenzhou. Conclusions： Our survey revealed a very initial and unbalanced development for the allergy subspecialty in Zhejiang Province. Doctor resources for allergic diseases were mainly from the specialties of ENT, Respirology, and Pediatrics, and the performance of diagnosis and treatment was mainly focused on provincial and municipal hospitals. Continuous education of allergies could be extended to primary healthcare centers and more efforts should be directed to those areas with poor medical resources.
