Objective To analyze the clinical efficacy of desloratadine citrate disodium and fexofenadine in the treatment of refractory urticaria . Methods 100 patients with refractory urticaria were randomly divided into observation group and control group according to the digital table method, with 50 cases in each group.The control group were treated with desloratadine citrate disodium, and the observation group were treated with fexofenadine on the basis of control group.The efficacy, immunity function ( CD3 +, CD4 +, CD4 +/CD8 +) , the changes of inflammatory factors [ procalcitonin ( PCT) , C-reactive protein ( CRP) ] and the quality of life were compared between the two groups.The adverse reaction rate in two groups was recorded in two groups.Results The total efficacy in observation group (88.0%) was significantly higher than that in control group (72.0%)(P<0.05).The indicators of immunity function in observation group were significantly higher than those in control group(P<0.05).The inflammatory factors in observation group were significantly lower than those in control group ( P<0.05 ) .The sleep and exercise quality rate of the observation group were significantly higher than those in control group(86.0% vs.68.0%,84.0% vs.66.0%,P<0.05).Conclusion The combination of desloratadine citrate disodium and fexofenadine in the treatment of refractory urticaria has a good effect, can effectively improve the immune function, reduce the secretion of inflammatory factors, thus effectively relieve the clinical symptoms, improve their quality of life, and has high security.

This study was aimed to discuss the distribution and protein expression level ofμ-opioid receptor (MOR) in hippocampus of premenstrual syndrome (PMS) liver-qi stagnation rat model, in order to initially reveal the action mechanism of PMS liver-qi stagnation and intervention effect ofShu-Yu (SY) capsule. Chronic restraint stress method was used to copy PMS liver-qi stagnation rat model.SY capsule ofTiao-Gan prescription was given as intervention. Immunofluorescence (IF) and western blot (WB) technique were used to detect MOR in hippocampal CA1 and CA3 brain area of rats from each group. The results showed that compared with the normal group, the hippocampus MOR distribution arrangement was messy with increased protein concentration in the model group (P< 0.01). After drug intervention, the MOR protein level returned to normal level. It was concluded that the pathogenesis of PMS liver-qi stagnation may be associated with high expression of MOR in hippocampus CA1 and CA3 region of rats. SY capsule can effectively correct and restore it to nearly normal level. It may be one of the central mechanisms in SY capsule treatment of PMS liver-qi stagnation.

Objective To investigate the effect of the isotretinoin combined with Dazhui acupoint bloodletting in the treatment of adolescent acne.Methods78 patients with adolescent acne from department of dermatology in our hospital were selected and randomly divided into the control group and the experiment group,39 cases in each group.The control group were treated by isotretinoin and the experiment group were treated on the base of the control group with Dazhui acupoint bloodletting.The clinical total effective rate, incidence of adverse reactions and recurrence rate after 6 months were compared between control group and experiment group.ResultsCompared with the control group after treatment, the clinical total effective rate were higher(P<0.05), the incidence of adverse reactions were lower(P<0.05), the 6 months after the recurrence rate of acne were lower(P<0.05).ConclusionThe application of different dimension an acid combined with Dazhui acupoint bloodletting treatment can improve the adolescent acne clinical total efficiency, reduce the incidence of adverse reaction rate and recurrence rate, and suitable for clinical, it is worth popularization and application.

Objective To establish a HPLC method for the content determination of irbesartan in drugs.Methods The diamonsil C18 column (150 mm ×4.6 mm,5μm) was used, with the mobile phase of phosphoric acid solution-acetonitrile(adjusted to pH 3.2 with triethylamine)(62:38).The column temperature was 35℃, with the UV detection wavelength of 245 nm and a flow rate of 1.0 mL/min.Results Irbesartan exhibited a good linear relationship with the peak area in the concentration range of 0.04-0.40 mg/mL with the correlation coefficient of 0.999 99.The average recovery was 98.37% with RSD of 0.7%(n=9).Conclusion This method is simple and accurate with wide linear range and good reproducibility,and can be used to determine the content of irbesartan in drugs.

Objective To establish an HPLC method for the simultaneous determination of the 6 aconitum alkaloids in compoundTengwu Ointment.Methods Chromatographic column was Aglient XDB-C18 column (4.6 mm × 250 mm, 5μm), with the mobile phase A of acetonitrile- tetrahydrofuran (25∶8), phase B was 0.1 mol/L ammonium acetate solution (0.5 mL acetic acid added to the 1000 mL) with gradient elution;the flow rate was 1 mL/min;the detection wavelength was set at 235 nm;the column temperature was 25℃.Results Aconitine was in the good linear range of 0.072-0.648μg (r=0.999 5), with the average recovery of 99.29%, RSD=1.25%. Mesaconitine was in the good linear range of 0.062-0.648μg (r=0.999 5), with the average recovery of 99.12%, RSD=0.85%. Hypaconitine was in the good linear range of 0.064-0.384μg (r=0.999 8), with the average recovery of 99.57%, RSD=1.07%. Benzoylaconine was in the good linear range of 0.056-0.672μg (r=0.999 2), with the average recovery of 98.11%, RSD=0.61%. Benzoylmesaconine was in the good linear range of 0.055-0.993μg (r=0.999 9), with the average recovery of 99.27%, RSD=1.10%. Benzoylhypaconine was in the good linear range of 0.078-0.702μg (r=0.999 8), with the average recovery of 99.08%, RSD=1.38%.Conclusion This method is simple, sensitive, repeatable and accurate, which can be used for determination of aconitum alkaloids in compoundTengwu Ointment.

Objective:To analyze the relationship between corrected Tp-e interval(Tp-ec), Tp-e/QT ratio and the degree of vein bridge vessel stenosis after coronary artery bypass grafting(CABG) in patients with left main coronary artery stenosis, and its predictive value for malignant electrophysiological events.Methods:Patients admitted to Beijing Anzhen Hospital affiliated to Capital Medical University from January 2018 to August 2019 were selected, coronary angiography was performed 5-7 years after coronary artery bypass grafting(CABG) due to recurrence of symptoms. 169 patients with >50% restenosis in SVG were selected. According to the degree of bridge angiography stenosis, the patients were divided into group A(50%-70% SVG restenosis, 105 cases) and group B(SVG restenosis >70%, 64 cases), routine electrocardiogram examination, measurement and correction of QT interval(QTc), Tp-ec and Tp-e/QT ratio were made. Patients were followed up 6 months, the occurrence of malignant ECG events is observed, and the area under the receiver operating characteristic( ROC) curve( AUC) was used to quantitatively evaluate the predictive power of Tp-ec and Tp-e/QT ratios for malignant ECG events. Results:The QTc, Tp-ec and Tp-e/QT ratios in group B were significantly greater than those in group A, and the differences were statistically significant( P<0.05). After multivariate logistic regression analysis, both the Tp-ec and Tp-e/QT ratios were independent influencing factors for the degree of vein bridge vessel stenosis>70%( P<0.05). After Pearson correlation analysis, both the Tp-ec and Tp-e/QT ratios were positively correlated with the degree of vein bridge vessel stenosis( r= 0.384 and 0.457, both P=0.000). A total of 162 cases(95.86%) were followed up, 25 cases of malignant electrophysiological events occurred. After ROC curve analysis, Tp-ec combined with Tp-e/QT ratio predicted coronary malignant electrophysiological events in patients with left main artery stenosis after GABG with AUC=0.924, which was significantly greater than 0.698 of the single index Tp-ec and 0.712 of the Tp-e/QT ratio, the differences were both statistically significant( P<0.05). Conclusion:Tp-ec and Tp-e/QT ratios are both positively correlated with the degree of vein bridge vessel stenosis after CABG in patients with left main coronary artery stenosis, the combined effect of them in predicting the occurrence of malignant electrocardiological events is good, and it is worth further research and application.

Objective To study the influence of high quality nursing mode on the quality of life in endoscopic retrograde cholangiopancreatography (ERCP) patients. Methods A total of 292 patients with ERCP were randomly divided into control group and observation group with 146 cases in each group by the randomized block design method. The control group was given the conventional nursing care. The observation group was given the high quality nursing care based on the conventional nursing care. The score of Quality of Life of the World Health Organization (WHOQOL- 100), Quality of Life Index of Gastrointestinal Tract (GIQLI), Hamilton Anxiety Scale (HAMA), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Visual Analogue Scale(VAS) before and after nursing care were observed and compared. The difference impact of two kinds of nursing mode on nursing quality between two groups was evaluated. Results WHOQOL-100 score in the observation group after treatment, including physiology and psychology and environment and social relations state such as grading, was respectively (59.3 ± 6.0), (61.8 ± 7.2), (60.3 ± 6.2), (62.8 ± 7.3) points and GIQLI index included self-conscious symptom and body physiological status and daily and social activities,such as state of emotional and psychological and the overall score, was respectively (79.8±4.9), (19.8±1.8), (14.7±1.9), (19.2±2.8), (105.7±6.6) points, which was (50.9±6.3), (52.5±6.7), (51.4±5.6), (53.4±7.1), (67.2±4.8), (15.6±1.9), (10.2±1.8), (16.3±2.3), (94.4 ± 6.2) points in control group, the difference between two groups was statistically significantly(t=1.876-2.327, P<0.05). HAMA score and SAS scores and SDS score and VAS score in the observation group after nursing was respectively (24.28 ± 4.78), (29.48 ± 6.54), (30.55 ± 7.32), (4.55 ± 1.18) points and respectively (36.68 ± 5.39), (41.72 ± 6.03), (42.65 ± 7.21), (6.07 ± 1.17) points in the control group, the difference between two groups was statistically significantly(t=2.876-4.012, P<0.05). Conclusions High quality nursing mode of ERCP in patients with perioperative patients of psychological and physiological all have different degrees of improvement and is suitable for popularization and application in clinic.

Objective To explore the association between clinical pathological characteristics and the expressions of epidermal growth factor receptor (EGFR) and protein kinase B (AKT) in gastric carcinomas.Methods The expressions of EGFR and AKT were measured with immunohistochemical method in the cancer tissues and cancer-adjacent normal tissues from 153 cases of patients with gastric cancer.The association between clinical pathological characteristics and their expressions were analyzed.Results The expressions of AKT and EGFR in gastric cancer tissues had no relationship with gender,age,pathological type,and the degree of differentiation (P ＞ 0.05).A positive correlation was existed between the EGFR and TNM stages (x2 =5.43,P ＜0.05).The AKT was positively related to the size,T stage,and TNM stage of the tumor,respectively (x2 =4.73,4.95,5.32,P ＜0.05 orP ＜0.01).The levels of AKT (x2=4.83,4.75,P ＜0.05) and EGFR(x2 =4.67,4.58,P ＜0.05) in the gastric cancer tissues with lymph node and/or distant metastasis were significantly higher than the gastric cancer tissues without metastasis,respectively.Conclusions The over-expressions of AKT and EGFR would benefit the diagnosis and stages of a gastric cancer and the determination of its metastasis.

Objective To assess the efficacy and safety of lanthanum carbonate in treatment of hyperphosphatemia in end-stage renal disease (ESRD).Methods Randomized controlled trails of lanthanum carbonate in treatment of hyperphosphatemia in ESRD patients were searched in the database of MEDLINE,Cochrane Central Register of Controlled Trials,EMBASE,CNKI,Wanfang database.Data extracted from the literatures were analyzed with the Cochrane Collaboration's RevMan 5.1 software.Results Lanthanum carbonate group was similar with calcium carbonate group in treating hyperphosphatemia[RR =1.00,95 ％ CI (0.92-1.09),P =0.97],and more effective than placebo [RR=4.69,95％ CI (2.63-8.39),P＜ 0.01] (intervention dose≤ 1500 mg) and [RR =18.92,95％ CI (7.42-48.22),P ＜ 0.01] (intervention dose ＞ 1500 mg).In comparison with calcium carbonate group,the incidence of hypercalcinemia of lanthanum carbonate group was lower [RR =0.06,95 ％ CI (0.01-0.72),P =0.03],while the incidence of nausea [RR =1.80,95 ％ CI(0.70-4.64),P =0.22],vomiting [RR =3.94,95％ CI (0.45-34.38),P=0.22] and constipation [RR=0.82,95％ CI (0.49-1.37),P=0.45] were similar.The incidence of nausea and vomiting of lanthanum carbonate group were similar with placebo,with lower incidence of constipation [RR =0.19,95 ％ CI (0.06-0.59),P ＜ 0.01].Conclusions The efficacy of lanthanum carbonate in treating hyperphosphatemia is similar with calcium carbonate.The incidence of hypercalcinemia of lanthanum carbonate is lower than that of calcium carbonate,and the incidence of gastrointestinal adverse effect such as nausea,vomiting and constipation are similar with calcium carbonate.

The X-ray computed tomography (CT) appearance of 4 cases with pulmonary cryptococcosis (PC) diagnosed by pathological examination in our hospital was retrospectively analyzed. The appearances of PC on CT were various: solitary lesion in 1 case, multiple lesions in single lobe in 2, and multiple lesions in multiple lobes in 1. There were total 52 lesions in 4 cases; the diameter of nodules or masses was 3 - 75 mm. Cavitations were found in 1 case; lesions appeared obviously enhanced and one lesion showed central necrosis. Two cases underwent pulmonary lobectomy; and 2 cases received core cutting needle biopsies, after antifungal therapy for 3 months to 1 year the lesions showed being absorbed. In summary, the CT appearance of PC is non-specific with various modes and forms. PC should be considered when multiple nodules or masses scattered in subpleural zone, accompanied with ground-glass opacity and obviously enhanced. The examination of pathogen and pathology at the beginning is crucial for improving diagnostic accuracy.