Objective:To explore the risk factors of blood pressure fluctuations during the dialysis period in maintenance hemodialysis (MHD) patients and their impact on long-term survival.Methods:A total of 100 cases of MHD patients admitted to Anhui Linquan People′s Hospital from September 2020 to May 2022 were selected and divided into high fluctuation group (coefficient of variation in systolic blood pressure>8.64%) and non-high fluctuation group (coefficient of variation in systolic blood pressure ≤ 8.64%). The clinical data of the two groups were compared, and the LASSO model was used to conduct the preliminary screening for each risk factor. The nomogram prediction model of blood pressure fluctuation during the dialysis period was drawn, and the receiver operating characteristic (ROC) curve and calibration curve was drawn to obtain the prediction efficiency and calibration degree of the nomograph model. Kaplan-Meier survival curve was drawn to compare the 1-year survival status of the two groups.Results:The results of single factor analysis showed that body mass index, dialysis age, urea clearance index, ultrafiltration volume, serum calcium, serum albumin, serum phosphorus, serum sodium, total parathyroid hormone (iPTH), serum uric acid, serum creatinine, C-reactive protein, alkaline phosphatase, early diastolic maximum blood flow in the left ventricle (peak E)/atrial systolic maximum blood flow of mitral valve (peak A), and left ventricular ejection fraction (LVEF) were risk factors for blood pressure fluctuation during dialysis ( P<0.05). The prediction model of nomograph was drawn, and the consistency index (C-index) was 0.941, the prediction sensitivity was 88.40%, and the specificity was 91.20%. Kaplan-Meier survival curve analysis showed that the 1-year survival rate in the high fluctuation group was lower than that in the non-high fluctuation group ( P<0.05). Conclusions:Blood pressure fluctuation during dialysis in MHD patients is related to blood sodium, calcium and phosphorus, iPTH, blood uric acid, albumin, peak E/peak A, and LVEF, and can affect the prognosis of patients, and attention should be paid to the monitoring and control of above indexes of the patients in order to improve the prognosis.

Objective:To investigate the predictive value of the triglyceride-high-density lipoprotein cholesterol-glucose-body mass index (TyHGB) and triglyceride-glucose-body mass index (TyG-BMI) in early pregnancy for gestational diabetes mellitus (GDM) and pregnancy outcomes.Methods:A retrospective analysis was conducted, a total of 600 pregnant women who underwent prenatal examinations at North China Medical and Health Group Xingtai General Hospital from August 2020 to August 2023 were collected. Participants were divided into GDM group (76 cases) and non-GDM group (524 cases) based on GDM occurrence, and further categorized into adverse pregnancy group (101 cases) and favorable pregnancy group (499 cases) based on outcomes. Multivariate Logistic regression was used to identify risk factors for GDM and adverse pregnancy. The predictive performance of TyHGB and TyG-BMI was evaluated using receiver operating characteristic (ROC) curves.Results:After adjusting for confounders, TyHGB and TyG-BMI were independent risk factors for GDM ( OR = 1.569, 95% CI 1.259 -1.955; OR = 1.109, 95% CI 1.029 - 1.038) and adverse pregnancy ( OR = 1.438, 95% CI 1.193 - 1.734; OR = 1.021, 95% CI 1.014 - 1.029). The area under the curve (AUC) for TyHGB and TyG-BMI alone in predicting GDM was 0.677 and 0.731, respectively. Combined prediction of GDM yielded an AUC of 0.793, with sensitivity of 72.37% and specificity of 65.81%. For adverse pregnancy, the AUC of TyHGB and TyG-BMI alone were 0.666 and 0.692, respectively, while their combination achieved AUC of 0.746, with specificity of 69.34% and sensitivity of 65.35%. Conclusions:TyHGB and TyG-BMI in early pregnancy are risk factors for GDM and adverse pregnancy outcomes. Their combination can enhance predictive efficacy for both conditions.

Objective:To investigate the predictive value of serum homocysteine (Hcy), neutrophil to lymphocyte ratio (NLR) and total imaging load score on cognition disorders in patients with small cerebral vascular disease (CSVD).Methods:A total of 106 CSVD patients treated in Shanxi Hongdong County People's Hospital from June 2021 to June 2024 were retrospectively selected as the study objects. The Montreal Cognitive Assessment Scale (MoCA) was used to assess cognitive function. Among them, 43 patients with cognition disorders and 63 patients without cognition disorders were evaluated. Another 30 healthy subjects over 60 years old were selected as control group. General data and serum Hcy, NLR and other indicators of the three groups were compared, MRI examination was performed, and the total imaging load score was calculated. Logistic regression was used to analyze the risk factors of cognition disorders in CSVD patients, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of Hcy, NLR and radiographic total load score for cognition disorders in CSVD patients.Results:The levels of Hcy, NLR and total imaging load scores in the CSVD group were higher than those in the CSVD group and the control group : (20.32 ± 3.24) μmol/L vs. (17.75 ± 2.81), (14.96 ± 3.84) μmol/L; 2.77 ± 0.75 vs. 2.27 ± 0.68, 1.93 ± 0.47; (1.28 ± 0.73) scores vs. (0.92 ± 0.55), (0.36 ± 0.21) scores, there were statistical differences ( P<0.05). The results of Logistic regression showed that Hcy, NLR and total load score were risk factors for cognition disorders ( P<0.05). The results of ROC curve showed that the area under the curve (AUC) of Hcy, NLR, total imaging load score combined prediction of cognition disorders was 0.798. Conclusions:Hcy, NLR and total imaging load score are risk factors for cognition disorders in CSVD, and have certain predictive value for cognition disorders.

Objective:To investigate the short-term clinical efficacy of two fixation methods, mini-titanium plate fixation and suture suspension, in cervical posterior unilateral laminoplasty, and to explore the relationship between changes in the cervical sagittal sequence and therapeutic outcomes.Methods:A retrospective analysis was conducted on 55 patients who underwent cervical posterior unilateral laminoplasty with mini-titanium plate fixation and 50 patients with suture suspension at the First People's Hospital of Lianyungang from September 2020 to January 2023. All patients were followed up for 12 months, and the axial symptoms was recorded. The main clinical efficacy evaluations included before surgery and 12 months after surgery visual analog score (VAS) for neck pain, Japanese Orthopaedic Association score (JOA) and neck disability index (NDI). Four parameters were recorded before surgery and 12 months after surgery to assess the sagittal sequence: C 2-7 sagittal vertical axis (C 2-7SVA), T 1 slope angle (T 1s), C 2-7Cobb angle and cervical range of motion. Results:The mini-titanium plate fixation group had 5 cases of axial symptoms, while the traditional suture suspension group had 16 cases; the postoperative VAS, JOA and C 2-7Cobb angle in the mini-titanium plate fixation group were all less than those in the suture suspension group, with statistically significant differences ( P<0.05). Specifically, the postoperative VAS in the mini-titanium plate fixation group was (1.93 ± 1.42) points, and (2.67 ± 2.15) points in the suture suspension group ( P = 0.049); the JOA was (10.39 ± 2.20) points in the mini-titanium plate fixation group and (9.62 ± 1.52) points in the suture suspension group ( P = 0.012); the C 2-7Cobb angle was (21.087 ± 3.564)° in the mini-titanium plate fixation group and (23.092 ± 1.265)° in the suture suspension group ( P = 0.003). There was no statistical difference in operation time and blood loss between two groups ( P>0.05). The postoperative C 2-7SVA, T 1s and range of motion in the traditional suture suspension group were less than those in the mini-titanium plate fixation group, with statistically significant differences ( P<0.05). Specifically, the postoperative C 2-7SVA was (25.700 ± 3.035) mm in the mini-titanium plate fixation group and (23.946 ± 3.079) mm in the suture suspension group ( P = 0.004); the postoperative T 1s was (28.770 ± 2.361)° in the mini-titanium plate fixation group and (26.746 ± 3.198)° in the suture suspension group ( P = 0.004); the postoperative range of motion was (32.651 ± 4.995)° in the mini-titanium plate fixation group and (28.672 ± 5.874)° in the suture suspension group ( P = 0.003). Conclusions:Cervical posterior unilateral laminoplasty with mini-titanium plate fixation can effectively improve VAS, JOA, and restore neurological function, maintaining the cervical spine's sagittal balance, stability, and maximum range of motion.

Objective:To comparatively the efficacy of the combined external fixator and the Ilizarov in the treatment of open tibia-fibula fractures and their influence on postoperative infection.Methods:A total of 215 patients with open tibio-fibula fractures diagnosed and treated at Tianjin Medical University General Hospital Airport Site from January 2021 to January 2024 were retrospectively selected as the research subjects. They were divided into the observation group (110 cases, using the combined external frame) and the control group (105 cases, using theIlizarov) according to the types of external fixators adopted. The clinical efficacy, bone healing condition, X-ray callus score, and serological indicators, including the bone morphogenetic protein (BMP-2), vascular endothelial growth factor (VEGF), osteocalcin (OC), C-reactive protein (CRP) in the two groups were compared. The America Orthopedic Foot & Ankle Society(AOFAS) score, Hospital for Special Surgery (HSS) score, and Health Survey Scale (SF-36) score were applied to evaluate the recovery of patients, and the postoperative infection conditions in the two groups were compared.Results:At 12 months after the operation, the excellent and good rate of clinical efficacy in the observation group was higher than that in the control group:90.00%(99/110) vs. 80.00%(84/105), there was statistical difference ( χ2 = 4.24, P<0.05). The complete weight-bearing time, swelling elimination time, bone healing time and postoperative hospital stay in the observation group were shorter than those in the control group:(144.73 ± 15.48) d vs. (152.12 ± 15.55) d, (11.25 ± 1.34) d vs. (13.18 ± 1.37) d, (123.01 ± 12.53) d vs. (136.38 ± 13.45) d, (30.15 ± 3.24) d vs. (31.47 ± 3.48) d, there were statistical differences ( P<0.01). The X-ray callus scores in the observation group at 1 week and 1, 3 and 6 months after the operation were higher than those in the control group: (1.37 ± 0.15) scores vs. (1.28 ± 0.14) scores, (7.65 ± 0.83) scores vs. (5.64 ± 0.75) scores,(12.34 ± 1.25) scores vs. (10.78 ± 1.16) scores,(14.52 ± 1.56) scores vs.(12.11 ± 1.35) scores, there were statistical differences ( P<0.01). Six months after the operation, the levels of BMP-2, VEGF and OC in the observation group were higher than those in the control group: (84.23 ± 8.51) ng/L vs. (76.79 ± 7.82) ng/L, (17.26 ± 1.83) ng/L vs. (15.34 ± 1.67) ng/L, (18.34 ± 1.92) μg/L vs. (6.48 ± 1.75) μg/L; while CRP was lower than that in the control group: (6.49 ± 0.76) mg/L vs. (7.13 ± 0.78) mg/L; there were statistical differences ( P<0.01). The scores of AOFAS, HSS and SF-36 in the observation group at 6 months after the operation were higher than those in the control group: (76.34 ± 7.85) scores vs. (70.11 ± 7.49) scores,(70.12 ± 7.63) scores vs. (67.77 ± 6.68) scores, (93.57 ± 10.34) scores vs. (85.73 ± 8.65) scores, there were statistical differences ( P<0.01 or <0.05). The patients were followed up for 12 months after the operation. There was no statistical difference in the incidence of complications between the two groups ( P>0.05). Conclusions:Compared with the Ilizarov, the combined external fixator has a better therapeutic effect in the treatment of open tibia-fibula fractures. It can promote the healing of bone wounds, improve joint function and quality of life, and has good safety.

Objective:To explore the predictive value of positive lymph node ratio (LNR) for tumor specific mortality in cervical cancer patients after surgery for 5 years.Methods:A total of 120 patients with cervical cancer with lymph node metastasis admitted to the Affiliated Hospital of Jining Medical University from January 2017 to December 2018 were retrospectively selected. The patients were followed up for 5 years and divided into a death group (48 cases) and a control group (72 cases) according to whether tumor-specific death occurred after surgery. The main clinical features and LNR differences between the two groups were compared. The predictive value of LNR for tumor-specific death was analyzed by receiver operating characteristic(ROC) curve, and the risk factors for tumor-specific death in patients with cervical cancer at 5 years after surgery were analyzed by multivariate Logistic retrospective analysis.Results:The low differentiation rate and the rate of periuterine invasion, the rate of pelvic invasion, the number of lymph node metastasis and LNR in the death group were higher than those in the control group: 47.92%(23/48) vs.16.67%(12/72), 58.33%(28/48) vs. 27.78%(20/72), 29.17%(14/48) vs. 9.72%(7/72), (9.35 ± 4.04) nodes vs. (5.07 ± 2.74) nodes, (46.01 ± 19.66)% vs.(23.04 ± 13.76)%, there were statistical differences ( P<0.05). The results of ROC curve analysis showed that LNR was valuable in predicting the tumor specific mortality in cervical cancer patients after surgery within 5 years, with areas under the curve of 0.832 (95% CI 0.760 - 0.905). The results of multivariate Logistic retrospective analysis showed that LNR>30.43%, poorly differentiated cancer, parametrial infiltration and pelvic infiltration were independent risk factors for tumor specific death in cervical cancer patients at 5 years after surgery ( P<0.05). Conclusions:The LNR has a high predictive value for tumor specific mortality in cervical cancer patients after 5 years of surgery, and can be used as a predictive indicator for patient's prognosis.

Objective:To explore the diagnostic value of serum solute carrier family 7 member 11 (SLC7A11), urinary retinol-binding protein (RBP) and transferrin (TRF) for acute kidney injury (AKI) in patients with sepsis.Methods:The clinical data of 204 patients with sepsis from January 2020 to December 2023 in the Second Affiliated Hospital of Xi′an Medical College were retrospectively analyzed. Among them, 102 patients complicated with AKI (AKI group), including Kidney Disease: Improving Global Outcomes (KDIGO) classification Ⅰ stage 43 cases, Ⅱ stage 36 cases, Ⅲ stage 23 cases; 102 patients did not complicate with AKI (non-AKI group). Additionally, 102 healthy individuals from the same period were selected as a healthy control group. Enzyme-linked immunosorbent assay was used to detect the serum expression level of SLC7A11, and fully automatic biochemical analyzers were used to detect urinary RBP and TRF levels. For patients in AKI group and non-AKI group, the sequential organ failure assessment (SOFA) was recorded; fully automatic analyzers were used to test hematological indicators, including creatinine, hemoglobin, platelet, albumin, uric acid, lactate, procalcitonin and C-reactive protein, and estimated glomerular filtration rate (eGFR) was calculated. Multivariate Logistic regression analysis was used to analyze the independent risk factors of AKI in patients with sepsis. Receiver operating characteristic (ROC) curve was plotted to analyze the values of serum SLC7A11 and urinary RBP, TRF in assessing the risk of AKI in patients with sepsis.Results:The serum SLC7A11 and urinary RBP, TRF in non-AKI group and AKI group were significantly higher than those in healthy control group: (28.66 ± 6.22) and (36.18 ± 7.29) ng/L vs. (14.32 ± 2.63) ng/L, (1.20 ± 0.25) and (1.47 ± 0.31) mg/L vs. (0.44 ± 0.08) mg/L, (1.82 ± 0.39) and (2.26 ± 0.45) mg/L vs. (1.08 ± 0.19) mg/L, furthermore the indexes in AKI group were significantly higher than those in non-AKI group, and there were statistical differences ( P<0.05). The serum SLC7A11 and urinary RBP, TRF in patients with KDIGO Ⅱ stage and Ⅲ stage were significantly higher than those in patients with KDIGO Ⅰ stage: (37.16 ± 7.41) and (45.20 ± 8.29) ng/L vs. (30.53 ± 6.46) ng/L, (1.50 ± 0.28) and (1.72 ± 0.35) mg/L vs. (1.31 ± 0.26) mg/L, (2.26 ± 0.46) and (2.77 ± 0.59) mg/L vs. (1.99 ± 0.40) mg/L, furthermore the indexes in patients with KDIGO Ⅲ stage were significantly higher than those in patients with KDIGO Ⅱ stage, and there were statistical differences ( P<0.05). The SOFA, creatinine and lactate in AKI group were significantly higher than those in non-AKI group: 12 (9, 15) scores vs. 7 (5, 9) scores, (133.71 ± 13.58) μmol/L vs. (108.18 ± 14.32) μmol/L and (13.61 ± 3.57) mmol/L vs. (10.95 ± 3.10) mmol/L, the albumin and eGFR were significantly lower than those in non-AKI group: (21.48 ± 2.48) g/L vs. (24.85 ± 2.83) g/L and (51.57 ± 9.64) ml/(min·1.73 m 2) vs. (59.21 ± 10.67) ml/(min·1.73 m 2), and there were statistical differences ( P<0.01); there were no statistical differences in hemoglobin, platelet, uric acid, procalcitonin and C-reactive protein between two groups ( P>0.05). Multivariate Logistic regression analysis result showed that the high SOFA, creatinine, lactate, SLC7A11, urinary RBP, urinary TRF, and low eGFR, albumin were independent risk factors for AKI in patients with sepsis ( OR = 4.864, 5.631, 2.315, 5.862, 6.852, 6.218, 0.328 and 0.226; 95% CI 1.701 to 13.907, 1.803 to 17.585, 1.350 to 3.969, 2.115 to 16.242, 2.177 to 21.566, 1.900 to 20.353, 0.151 to 0.713 and 0.092 to 0.555; P<0.01). The ROC curve analysis result showed that the area under the curve of the combined assessment of serum SLC7A11 and urinary RBP, TRF for AKI in patients with sepsis was significantly larger than serum SLC7A11 and urinary RBP, TRF alone (0.892 vs. 0.774, 0.765 and 0.755), and there was statistical difference ( Z = 2.97, 3.20 and 3.38; P<0.01). Conclusions:The elevated expression levels of serum SLC7A11 and urinary RBP and TRF in patients with sepsis have a high value for the combined detection and assessment of AKI.

Objective:To compare the clinical efficacy of TINAVI orthopaedic robot-assisted pedicle screw placement and free-hand pedicle screw placement in the treatment of lumbar spondylolysis in adolescents.Methods:The clinical data of 65 adolescents with lumbar spondylolysis who underwent surgery in Honghui Hospital, Xi′an Jiaotong University from January 2021 to December 2022 were analyzed retrospectively, including 20 males and 45 females with an age of (21.5 ± 4.3) years. The distribution of spondylolysis included 2 cases of L 3, 13 cases of L 4, 50 cases of L 5. According to the Meyerding classification of spondylolisthesis degree, there were 52 cases of grade Ⅰ, 5 cases of grade Ⅱ and 8 cases without spondylolisthesis, all of which were complicated with intractable back pain. All patients were treated with double segmental pedicle screw reduction and autogenous iliac bone graft. According to different screw placement methods, they were divided into TINAVI orthopedic robot-assisted screw placement group (robot group, 32 cases) and free-hand screw placement group (free-hand group, 33 cases). CT was re-examined after operation. The satisfactory rate of pedicle screw placement and cortical penetration rate were calculated according to Neo standard, and the superior articular process invasion rate of screw was calculated by Babu standard. The operation time, intra-operative blood loss, post-operative drainage, hospital stay, satisfactory rate of screw placement, cortical puncture rate and superior articular process invasion rate were compared between the two groups, and the operative complications and bony fusion time of isthmus were recorded. The visual analogue score (VAS) of lumbar pain, the score of Japanese Orthopaedic Association (JOA) and the score of Oswestry dysfunction (ODI) were compared between the two groups before operation, 1 month after operation and 1 year after operation. Results:There was no significant difference in preoperative general data between the two groups ( P>0.05). All patients completed the operation successfully, anatomical reduction was achieved in patients with spondylolisthesis. No serious operative complications such as nerve and vascular injury occurred during surgery. The operation time in the robot group was longer than that in the free-hand group: (82.6 ± 6.8) min vs. (60.5 ± 7.1) min. There was no significant difference in intra-operative blood loss, post-operative drainage and hospital stay between the two groups ( P>0.05). A total of 128 screws were placed in the robot group, and 132 screws were placed in the freehand group. There were significant differences in the satisfaction rate of screw insertion, cortical penetration rate and articular process invasion rate between the two groups: 96.9%(124/128) vs. 90.9%(120/132), 3.1%(4/128) vs. 9.1%(12/132), 2.3%(3/128) vs. 7.6%(10/132) ( P<0.05). One year after surgery, the isthmus of all patients fused well, the reduction was not lost, the intervertebral disc had no degeneration, and the instrumentation was removed. The VAS, JOA score and ODI score of the two groups at 1 month and 1 year after operation were significantly better than those before operation ( P<0.05). The VAS of the robot group was lower than that of the free-hand group at 1 month and 1 year after operation: (1.6 ± 0.8) points vs. (2.7 ± 0.9) points, (0.3 ± 0.1) points vs. (1.5 ± 0.2) points, the difference is statistically significant ( P<0.05). However, there was no significant difference in JOA score and ODI score between the two groups ( P>0.05). Conclusions:TINAVI orthopaedic robot assisted screw placement and free-hand screw placement can both effectively treat lumbar spondylolysis in adolescents. Compared with free-hand screw placement, TINAVI orthopedic robot assisted screw placement can further improve the accuracy and improve patients′ lumbodorsal pain.

Objective:To observe the clinical effect of urokinase along the pipeline under offline status to dissolve dialyzer microthrombus in patients undergoing continuous renal replacement therapy (CRRT).Methods:A prospective research method was adopted. A total of 248 CRRT patients with dialyzer microthrombus in Sinopharm-Gezhouba Central Hospital from January 2017 to December 2021 were selected. The patients were divided into experimental group (continued CRRT treatment after urokinase along the pipeline under offline status to dissolve dialyzer microthrombus) and control group (continued CRRT treatment after dialyzer replacement) by random number table method with 124 cases in each group. The baseline data were recorded, including gender, age, primary disease, hemoglobin, platelet count, hematocrit, plasma albumin, D-dimer, fibrinogen, anticoagulant method and symptoms associated with dialyzer microthrombus. The blood indexes were detected before and after treatment of microthrombus, and the symptom scores were performed. The blood indexes included creatinine, urea nitrogen, β 2 microglobulin (β 2-MG), international normalized ratio (INR), hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α); and the symptom scores included acute physiology and chronic health status score Ⅱ (APACHE Ⅱ) and (APACHE Ⅱ) and sequential organ failure score. The initial transmembrane pressure, transmembrane pressure before disembarkation, CRRT treatment extension time and coagulation classification were recorded. In experimental group, the blood coagulation function indexes before and after treatment were detected, including prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT) and fibrinogen (Fib). The adverse reactions were recorded, including black stools, arrhythmias and wound bleeding. Results:There were no statistical differences in baseline data, initial transmembrane pressure, transmembrane pressure before disembarkation, CRRT treatment extension time and coagulation classification between two groups ( P>0.05). There were no statistical differences in creatinine, urea nitrogen, β 2-MG, INR, hs-CRP, IL-6, TNF-α, APACHE Ⅱ and SOFA before treatment between two groups ( P>0.05); after treatment, the indexes in both groups were significantly lower than before treatment, and the indexes in experimental group were significantly lower than those in control group: (179.1 ± 41.2) μmol/L vs. (187.1 ± 53.9) μmol/L, (7.3 ± 2.8) mmol/L vs. (9.3 ± 2.5) mmol/L, (2.5 ± 0.6) mg/L vs. (4.2 ± 0.7) mg/L, 1.0 ± 0.3 vs. 1.8 ± 0.5, (8.7 ± 1.1) mg/L vs. (10.6 ± 2.4) mg/L, (21.5 ± 12.7) ng/L vs. (29.5 ± 10.3) ng/L, (20.2 ± 6.1) ng/L vs. (26.6 ± 7.2) ng/L, (12.1 ± 6.9) scores vs. (17.2 ± 5.2) scores and (5.9 ± 1.8) scores vs. (6.8 ± 1.9) scores, and there were statistical differences ( P<0.05). In experimental group, there were no statistical differences in PT, APTT, TT and Fib between before treatment and after treatment ( P>0.05). The incidence of adverse reactions in experimental group was significantly lower than that in control group: 4.03%(5/124) vs. 12.90%(16/124), and there was statistical difference ( χ2 = 6.30, P<0.05). Conclusions:The urokinase along the pipeline under offline status to dissolve dialyzer microthrombus in patients undergoing CRRT is safer, cheaper and more efficient. It can improve the biocompatibility of tissue with dialyzer and pipe, prolong the use time of the dialyzer, and complete renal replacement therapy.

Objective:To investigate the effects of combination of omalizumab and olofatadine on the improvement of symptoms of refractory chronic spontaneous urticaria (CSU) and its influence on serum immunoglobulin E (IgE) and T cell subsets.Methods:A prospective study was conducted to include 100 patients with refractory CSU who were treated at the Hangzhou Linping District Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to December 2023. They were divided into the control group and the study group by random number table method. The control group was given olopatadine, 5 mg/ time, 2 times/d, orally; the study group was given the same dose of olofatadine as the control group, plus omazumab, 300 mg/4 weeks, subcutaneous injection. The clinical efficacy of the two groups was compared. The levels of IgE, interleukin-4 (IL-4), interferon -γ (IFN-γ) and T cell subsets before treatment and 12 weeks after treatment were compared between the two groups. The symptom scores and the occurrence of adverse reactions before and after treatment were compared between the two groups.Results:The effective rate in the study group was higher than that in the control group : 96.00% (48/50) vs. 82.00% (41/50), there was statistical difference ( χ2 = 5.01, P<0.05). After treatment, the levels of IgE and IL-4 in the study group were lower than those in the control group : (74.26 ± 12.34) kU/L vs. (93.12 ± 14.62) kU/L, (25.13 ± 3.47) ng/L vs. (29.35 ± 5.24) ng/L, while the level of IFN-γ was higher than that in the control group : (12.72 ± 1.86) ng/L vs. (11.15 ± 1.59) ng/L, there were statistical differences ( P<0.01). After treatment, the level of CD 4+/CD 8+ in the study group was higher than that in the control group 1.50 ± 0.13 vs. 1.01 ± 0.24, there was statistical difference ( P<0.01). After treatment, the scores of refractory CUS symptoms, such as the number of wheals, wheal diameter, pruritus degree and duration in the study group were lower than those in the control group, there were statistical differences ( P<0.05). The total proportion of patients with adverse reactions in the two groups had no statistical difference ( P>0.05). Conclusions:In the treatment of refractory CSU, the combination of omazumab and olatadine can reduce IgE level, improve serum factor indexes, promote the restoration of T cell subpopulation balance, and improve wind mass, pruritosis and other symptoms, with significant clinical efficacy and certain drug safety.