AIM: To evaluate the efficacy and safety on the radio-heating-chemotherapy in treatment of patients with malignant pleural effusion (MPE). METHODS: 60 patients of MPE were randomly devided into two groups, radio-chemotherapy group (treatment group) and chemotherapy group (control group). The drugs, according to the types of tumor cells, were select to take intravenous injection and pleural cavity administration. The patient’s pleural cavity was drained continuously by pleurocentesis. These treatments were made once two week lasting for 4-6 weeks with NS 30 ml+cisplatin 60 mg by perfusion of pleural cavity. After the perfusin of pleural cavity, radio-heating was performed 60-90 min, twice one week for 8-10 times in the treatment group. RESULTS: The response rate was 90% (CR+PR) in the treatment group, and 67% (CR+PR) in the control group. The rates were higher than those in the control group (P

Objective To assess if evaluating with Peabody's fine motor development scale with 4 degree grading is more sensitive than with 3 degree grading, and whether or not it is feasible to evaluate by quantization with monthly averages. Methods A total of 864 normal children aged 1 month to 60 months were evaluated with the Peabody scale using 4 degree grading and 3 degree grading. The development results were averaged by month to express the development. Results Both ways, the monthly averages of children 4-9 months old were higher than the others. The values obtained with 4 degree grading were lower than those with 3 degree grading in each functional area, and the difference was more obvious with increasing age, but the differences were not statistically significant. With 3 degree grading the total score was equal to the actual score after the age of 9 months, but with 4 degree grading this was not true until at least 18 months. Conclusions Evaluating with Peabody's fine motor scale with 4 degree grading and quantization using monthly averages is reliable and more sensitive than 3 degree grading.

Objective To explore the effects of group sand play on the behavior of cerebral palsy (CP)children with behavioral problems.Methods Ninety children with CP aged 3-5 with behavioral problems were selected,after those with mental retardation had been excluded through the Peabody picture vocabulary test (PPVT).Their behavioral problems were diagnosed using Achenhach's child behavior check list (CRCL).The children were randomly divided into an experimental group and a control group with 45 cases in each.The experimental group received 10 weeks of sand play treatment in addition to routine rehabilitation.The controls received only routine rehabilitation.Results After treatment,the social withdrawal,depression,aggression and disruptive behavior scores of the 3-year olds in the experimental group were significantly lower than before treatment and significantly lower than those of the controls.For the 4 and 5 year-old boys the results were similar in terms of soclal withdrawal,depression,immaturity,sexual behavior,aggression and delinquent behavior,For the 4 and 5 year-old girls the scores for depression,somatic complaints,social withdrawal,compulsion,aggression,and hyperauctivity showed similar significant improvements.Conclusion Group sand play can improve the behavior and promote the mental health of CP children.

Objective To explore the cognition ,attitude and intention of seeking doctor on hierarchical diagnosis and treat-ment among the patients suffering from chronic diseases in Chongqing City .Methods A multistage stratified sampling method was adopted to investigate 1125 patients with chronic diseases extracted from 9 public hospitals as well as basic medical and health in-stitutions in 9 districts and counties of Chongqing City .Meanwhile ,the differences of intentions of seeking doctor and cognition situ-ation of hierarchical diagnosis and treatment were analyzed .Results The patients with chronic diseases in basic medical and health institutions were more likely to choose the basic medical and health institutions for seeking doctor than the patients treated in public hospitals ,the difference was statistically significant (χ2 = 190 .051 ,P<0 .01);31 .2% of the patients with chronic diseases never contacted the hierarchical diagnosis and treatment .The technical capabilities of basic medical and health institutions meeting treat-ment needs ,gradual improvement of medical condition and service level and trending to seeking doctor in basic medical and health institutions had statistical difference between the patients in public hospitals and patients in basic medical and health institutions (P<0 .01) .The aspects of understanding the current referral system between medical institutions and downward referral conducing the disease to obtain continuous long tern treatment had statistical difference between the patients in public hospitals and patients in basic medical and health institutions (P< 0 .01) .Conclusion In order to better carry out hierarchical diagnosis and treatment in Chongqing City ,it is necessary to perfect the supporting polices of hierarchical diagnosis and treatment for guiding the primary diag-nosis in the patients with chronic disease ,meanwhile establish an efficient dual referral mechanism and enlarge the propaganda of hi-erarchical diagnosis and treatment policy .

Objective To assess the effectiveness and safety of combining methylprednisolone with myco-phenolate mofetil in managing moderate to severe active Graves'ophthalmopathy(GO),and to compare its efficacy against methylprednisolone monotherapy.Methods A retrospective study was conducted to select patients with moderate to severe active GO who received treatment at the Department of Endocrinology and Metabolism,Guizhou Medical University Affiliated Hospital,from January 2019 to January 2024.The patients were divided into two groups:a combination group receiving methylprednisolone combined with mycophenolate mofetil,and a mono-therapy group receiving methylprednisolone alone.The objective was to compare changes in visual score,appearance score,clinical activity score(CAS),eye protrusion,eye fissure width,and eye movement between the two groups of patients while documenting any adverse events.Results A total of 98 patients were enrolled in the study,comprising 32 patients in the combination group and 61 patients in the monotherapy group.Both groups exhibited improvements in quality of life scores,CAS,and degree of protrusion following treatment compared to baseline.However,at the end of the 12-week treatment period,there was no statistically significant difference(P>0.05)observed between the two groups regarding changes in visual scores,appearance scores,CAS,protrusion degree,fissure width,and proportion of reduced eye movement before and after treatment.Notably though,the combined therapy group demon-strated a significantly higher improvement rate for pain relief and reduction of eyelid congestion during eye movement when compared to the monotherapy group(P<0.001).At the endpoint of treatment,there were no statistically significant differences in appearance score,protrusion degree,tear width,and reduction in eye movement between the two groups before and after treatment(P>0.05).The combination group exhibited higher visual scores and greater improvement in CAS compared to the monotherapy group(P<0.05),along with a higher rate of eyelid edema improvement(P<0.05).At 12 weeks,the monotherapy group had an effective rate of 65.0%,while the combination group had an effective rate of 66.7%.By week 24,the combined group achieved an effective rate of 80.0%.The over-all effectiveness at week 12 and treatment endpoints did not show any statistically significant differences between the two groups(P>0.05).No cases of leukopenia or severe infection occurred in the combination group.Conclusions The combination therapy of methylprednisolone and mycophenolate mofetil demonstrates efficacy,tolerability,and safety in the treatment of moderate to severe active GO.While the overall effectiveness of this combination may not surpass that of hormone therapy alone,it exhibits potential superiority in improving visual scores,eyelid congestion,eyelid edema,and eye movement pain when compared to hormone therapy alone.

OBJECTIVE：To establish fingerprint of Lonicera japonica ，and to study its anti-inflammatory spectrum-effect relationship. METHODS ：HPLC was adopted. The determination was performed on Diamonsil C 18 column with mobile phase consisted of 0.1％ formic acid solution-acetonitrile （gradient elution ）at the flow rate of 1.0 mL/min. The column temperature was 30 ℃，and detection wavelength was 238 nm. The sample size was 10 μL. Using chlorogenic acid as reference，HPLC fingerprint of 10 batches of L. japonica from different production areas was established according to TCM Chromatographic Fingerprint Similarity Evaluation System （2012 edition）. By comparing with reference substance ，chemical constituents corresponding to common peaks were identified ，and the similarity analysis was conducted. Acute and chronic inflammatory models of mice induced by xylene ，carrageenan and cotton ball were used to evaluate inhibition rate of 10 batches of L. japonica to ear，foot and granuloma swelling； the average value was calculated as the comprehensive pharmacodynamic index. The spectrum-effect relationship with HPLC fingerprint of L. japonica and anti-inflammatory effect was analyzed by grey relational analysis （GRA）and partial least squares regressiosn （PLSR）based on common peak area and comprehensive pharmacodynamic index . Chromatographic peaks with correlation＞0.7 and regression coefficient of PLSR model ＞0 were characteristic peaks. The percentage of peak areas of characteristic peaks to peak areas of common peak was calculated in 10 batches of L. japonica （e.g.“peak ratio ”）. RESULTS ： There were 25 common peaks in HPLC fingerprints of 10 batches of L. japonica ，with similarity of 0.775-0.994. Totally 9 peaks were confirmed ，i.e. rutin （peak 18），hyperoside（peak 20），isochlorogenc acid B （peak 22），galuteolin（peak 21），chlorogenc acid（peak 9），loganin（peak 10），neochlorogenic acid （peak 2），isochlorogenic acid C （peak 25），isochlorogenic acid A （peak 23）. All 10 batches of L. japonica had inhibitory effects on ear swelling ，foot swelling and granuloma ，with average inhibitory rate of 47.95％-56.52％. The correlation by GRA was peak 8＞12＞18＞16＞3＞11＞20＞22＞19＞21＞1＞9＞10＞13＞24＞14＞2＞ 17＞25＞23＞5＞4＞15，and all of correlations were greater than 0.7. The regression coefficient of PLSR for peaks 2，4，5，7，8， 10，12，13，14，15，16，17，18，20，21，22，24 were all greater than 0；those peaks were positively correlated with anti-inflammatory effect and were characteristic peaks except for peak 7； among them ，VIP values of peaks 5，8，10，16，18， 20，24 were greater than 1. The peak ratio of 10 batches of L. japonica was 58.61％-71.19％. CONCLUSIONS ：HPLC fingerprint of 10 batches of L. Japonica is successfully established. 10 batches of samples have similar components ，and the content of anti-inflammatory components is relatively high. The proportion of characteristic peaks to common peaks should not be less than 51.8％.