Objective To analyze the clinical features of eosinophilic granulomatosis with polyangiitis (EGPA).Methods The clinical characteristics,laboratory test,therapeutic regimen,pathology and imaging diagnosis in 23 cases with EGPA from the First Affiliated Changhai Hospital of Second Military Medical University within June 2007 to January 2013 were retrospectively analyzed.Results There were 14 males and 9 females,with the age ranged from 21 to 68 years.The mean age was (42±9) years.The overall prevalence of asthma was 78％(18/23).The allergic rhinitis accounted for 61％(14/23).The maxillary sinuses were the most frequendy involved,which accounted for 57％(13/23).Skin involvement was 57％(13/23),peripheral neuritis was 70％(16/23).Central nervous system involvement presented cerebrovascular event.Cardiac involvement accounted for 48％(11/23),digestive system involvement accounted for 17％(4/23).The outcome of auxiliary laboratory test revealed that 96％(22/23) patients expressed significantly higher levels of IgE and 70％(16/23) patients carried anti-neutrophil cytoplasmic antibodies (ANCA) which were presented as the perinuclear ANCA (p-ANCA).The patchy infiltrates of lung CT scan accounted for 69％ (11/23).EMG showed mononeuritis multiplex and symmetric sensory motor neuropathy.The abnormal ratios of ECG and Echocardiography were 48％(11/23),79％(11/14) respectively.The pathological manifestations were necrotizing vasculitis,eosinophilic tissue infiltration,and extravascular granulomas.Conclusion Our results confirm the heterogenicity in clinical presentation and lack of specificity.Early diagnosis and treatment will be helpful for good prognosis.

Objective:Effect of ICA (Icariin) was observed on immunosuppression mice caused by Cyclophosphamide(Cy).Methods:A total of 60 mice,expect control group mice,were injected Cy intraperitoneally [300 mg/(kg·d)],then randomly divided into modelgroup(saline),positive (shenqi,1 ml/d)groups,ICA groups[150,80,40 mg/(kg·d)].Saline,shenqi and ICA were perfused respectively for 10 successive days;All mice were sacrificed after 12 h of last administration for performing following experiments.Measuring SI and TI and calculating amounts of lymphocyte from spleen and peripheral blood;Proliferative reaction of splenic lymphocyte stimulated by ConA and LPS were detected by MTT assays.Killing activity of NK and CTL cells for colon26 and level of TNF-α production were measured by LDH method.Ratios of CD3~+ T and NKT in splenic lymphocyte (SPL) were studied by FACS.Results:ICA can recovery TI and SI of mice to normal level and boost the population of splenic lymphocyte (SPL) (P<0.01).After treatment with ICA,activities of NK cell and CTL cell were significantly improved,and the level of TNF-α was significantly elevated.The ratios of NKT and CD3+T in the ICA-treated group were increased obviously (P<0.01).Conclusion:ICA can enhance immunological function and alleviate the side effect of chemotherapy effectively.

ObjectiveTo evaluate the adverse events occurred during tumour necrosis factor (TNF)-αblocker treatment in Chinese Han population patients with ankylosing spondylitis (AS).MethodsThis study had enrolled 369 Chinese Han population patients with ankylosing spondylitis.They all received TNF-αblocker treatment in the hospital.All 1011 administration were recorded in total.All of them were evaluated for adverse events 2 hours after injection,126 of them had received long-term TNF-α blocker injection,and they were followed-up at week 8,12,52,104.Mild immediate adverse events and long-term adverse events were all counted.SPSS 10.0 software package was used for Fisher's exact test.ResultsThree hundred and sixty-nine patients had 1011 administrations in total,652 had received rhTNFR:Fc,316 had infliximab,21had etanercept,22 had adalimumab injections.Adverse events 2 hours after injection were:17 (2.6％) for rhTNFR:Fc,12 (3.8％) for infliximab,0 for etanercept,1 (4.5％) for adalimumab.Twenty adverse events were mild(12 for rhTNFR:Fc,9 for infliximab),5 events were moderate(3 for rhTNFR:Fc,1 for infliximab,1 for adalimumab),4 events were severe(2 for rhTNFR:Fc,2 for infliximab).The frequency of adverse events were comparable between rhTNFR:Fc and Infliximab injection in immediate adverse reactions (P=0.31).One hundred and twenty-six (69 rhTNFR:Fc,57 infliximab) patients had long-term usage,and were followed-up at week 8,12,52,104,39 patients had adverse reactions:20 (51.3％) for rhTNFR:Fc,19(48.7％) for infliximab.Thirty-seven patients had infectious events(94.9％ ),1 neurological event(2.6％),and 1 patient had tuberculosis relapse (2.6％).Outcomes were comparable with rhTNFR:Fc and infliximab in long-term usage(P=0.69).ConclusionAttention should be paid to the above events in Chinese Han patients with ankylosing spondylitis who were treated with TNF-α blocker treatment.Special attention should be paid to those patients who are in their third or fourth injection.The occurrence of immediate reaction or long-term adverse events between rhTNFR:Fc and infliximab are comparable.

OBJECTIVE To analyze the effect of pharmaceutical practice of pediatric pharmacists providing internet medication consultation services. METHODS A total of 8 356 children’s medication cases through the “Our Pharmacists” online medication consultation platform （hereinafter referred to as “Our Pharmacists”） were collected from July 2020 to June 2022. The general information， disease type and irrational drug use were analyzed statistically. RESULTS Among 8 356 cases， 4 234 were male and 4 122 were female； the age of children was mainly from 12 months to 3 years old； the consulting diseases were mainly respiratory diseases （46.56%）， followed by digestive system diseases （18.41%） and skin system diseases （12.71%）. Among respiratory diseases， the proportion of irrational drug use was 92.30%， mainly including the use of antibiotics without indication （83.59%）， inappropriate selection of Chinese patent medicines （61.14%） and compound cold medicines （49.77%）， etc. Among digestive system diseases， the proportion of irrational drug use was 71.15%， mainly including not using oral rehydration salts （48.85%）， inappropriate use of probiotics （31.19%）， the use of antibiotics without indication （26.89%）， etc. A total of 4 273 evaluations of pharmacist services were received from child guardians， with a five-star rating of 99.88%. CONCLUSIONS Pharmacists provide pediatric medication consultation services through “Our Pharmacists”， providing individualized evidence-based medication suggestions， increasing the safety of drug use and satisfaction with pharmaceutical care， and ensuring the safety of children medication.