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.

Objective To evaluate the effect of ginsenoside pre-treatment on serotonin (5-hydroxytryptamine,5-HT),5-HT2A receptor (5-HT2A R),and 5-HT transporter (serotonin transporter,SERT) in serum,platelet lysate and brain tissue homogenates in SD rats with myocardial infarction (MI) or depression.Methods Eighty SD rats were randomized treated with ginsenoside or normal saline (NS).After 4 weeks,the rats were,then,randomized to four subgroups:the MI,the depression,the MI in combination with depression and sham subgroups.5-HT,5-HT2A R and SERT levels were detected in serum,platelet or brain.Results In the NS pre-treatment groups,serum 5-HT levels in sham rats (237.1 ± 32.0)pg/ml were higher than in MI (58.0 ± 11.6) pg/ml,depression (72.8 ± 2.3) pg/ml,and MI with depression rats (62.5 ± 10.2) pg/ml (all P =0.000).Pre-treatment of ginsenoside increased serum and platelet 5-HT in MI,depression and MI with depression rats compared with each corresponding NS treated subgroups (all P ＜ 0.005).However,treatment of ginsenoside lowered the 5-HT2A R expression in MI,depression,and MI with depression subgroups both in platelet and brain tissue homogenates compared with each corresponding NS treated subgroups (all P ＜ 0.05).As to SERT in platelet,treatment of ginsenoside increased its levels in depression rats (P =0.019),but lowered the levels in MI rats (P =0.001) compared with NS treated rats.There were no differences in brain 5-HT and SERT between ginsenoside and NS treated groups.Conclusions The 5-HT system responses differently to ginsenoside treatment under different cardiac and mental stress conditions.Ginsenoside plays an important role in regulation of 5-HT system.

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 explore the combined detection of B‐type natriuretic peptide (BNP) and glycosylated antigen 125 (CA125) in differential diagnosis of dyspnea .Methods BNP and CA125 were detected and compared among 106 cases with cardiac dyspnea ,56 cases with pulmonary dyspnea and 60 healthy subjects .Results BNP and CA125 levels of dyspnea patients were higher than healthy subjects ,and those of cardiac dyspnea patients were higher than pulmonary dyspnea patients (P<0 .05) .With the ag‐gravation of heart failure ,BNP and CA125 levels gradually increased .Combined detection of BNP and CA125 were with higher diag‐nostic sensitivity and specificity (P<0 .05) .After treatment ,BNP and CA125 levels significantly decreased (P<0 .05) .Conclusion Combined detection of BNP and CA125 could be with high specificity and sensitivity ,helpful for identifying cardiac or pulmonary dyspnea and dynamic observation of the disease .

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 study the protection of glutathione (GSH) on renal oxidative damage to mice which caused by mi‐crocystin‐LR(MC‐LR) .Methods Forty healthy KM mice were divided into five groups by randomly sampling ,which were saline control group ,GSH control group ,MC‐LR group ,low dose GSH +MC‐LR group and high dose GSH +MC‐LR group ,and the ex‐periment was lasting 15 days by intraperitoneal injection .Then we took out the kidney for pathological observation and detected the activity of CAT ,SOD ,GSH‐Px and the content of GSH ,MDA .Results Compared with control group ,the MC‐LR increased the content of MDA[(2 .31 ± 0 .22)nmol/mg prot ,P=0 .000] and decreased the content of GSH[(0 .68 ± 0 .02)mg/g prot] .The activi‐ty of CAT[(320 .54 ± 38 .99)nmol/mg prot] ,SOD[(180 .93 ± 15 .30)U/mg prot] ,GSH‐Px[(295 .11 ± 42 .40)U/mg prot](P<0 .05) .However ,after GSH was given ,compared with MC‐LR group ,MDA content[(1 .94 ± 0 .12)nmol/mg prot]of high dose GSH+MC‐LR group significantly decreased (P<0 .05) ,GSH content[(1 .01 ± 0 .08)mg/g prot ,(1 .08 ± 0 .16)mg/g prot]and CAT activity[(383 .46 ± 21 .98)nmol/mg prot ,(428 .50 ± 28 .61)nmol/mg prot] of both GSH groups significantly increased (P<0 .05) ,the activity of SOD[(222 .01 ± 11 .51)U/mg prot] and GSH‐Px[(358 .37 ± 20 .29)U/mg prot] of high dose GSH +MC‐LR group significantly increased (P<0 .05) .Conclusion MC‐LR may cause renal oxidative damage through promoting the lipid perox‐idation on renal cells .The GSH may reach a certain protective effect on kidney by reducing the lipid peroxidation ,improving the an‐tioxidant activity ,and removing oxygen free radicals .

Objective To investigate the value of clinical parameters in predicting the initiation of renal replacement therapy(RRT) in acute kidney injury (AKI) patients with cardiorenal syndrome (CRS).Methods A total of 75 AKI patients hospitalized with CRS were enrolled.All patients received pharmacologic therapy on the beginning 3 days.The patients whose heart function improved were divided into control group (n=39),and the patients whose heart function worsened were divided into RRT group (n=36).Clinical and laboratory data on the first day and the fourth day were collected and analyzed.The factors on the first day were labeled asⅠ ,and those on the fourth day were labeled asⅡ. The ratio of some parameters calculated were labeled asⅡ/Ⅰ .Area under curve (AUC) of receiver operating characteristic curve (ROC) of these factors was used to evaluate the sensitivity and specificity in predicting the initiation of RRT.Results The patients in RRT group had significantly higher levels of BNP-Ⅱ,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ (P ＜ 0.01),and lower levels of 24 hours urine volume-Ⅰ and 24 hours urine volume-Ⅱ (P ＜ 0.01).From ROC curve analysis,the AUC of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,creatinine Ⅱ / Ⅰ,BNP-Ⅱ levels and BNP Ⅱ/Ⅰ to predict RRT were 0.736,0.875,0.747,0.779 and 0.894 respectively.When the cutoff values of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,BNP-Ⅱ levels,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ were 905 ml (sensitivity 75％,specificity 94.9％),1450 ml (sensitivity 75％,specificity 100％),3360 ng/L (sensitivity 72.2％,specificity 100％),1.37 (sensitivity 75％,specificity 100％) and 1.25 (sensitivity 72.2％,specificity 94.4％) respectively,the value of the parameters to predict RRT was high.Conclusions The 24 hours urine volume,BNP levels after treatment and the dynamic changes of BNP levels and creatinine levels can be used as predictors of the initiation of RRT in the AKI patients with CRS.

Objective To evaluate the CT features of the uncommon neoplasms of the paranasal sinuses and nasal cavity and related differentiate diagnosis.Methods CT manifestation of 26 cases with uncommon neoplasm of the paranasal sinuses and nasal cavity confirmed by histopathology were retrospectively analyzed and compared with 9 cases of common malignant neoplasm. Results All cases had soft-tissue mass with sinusitis in most cases (27/35).In benign group, 7 cases appeared as common benign tumor except for the hemangioma with marked enhancement and meningioma with calcification . In the malignant group, melanoma was small in volume and malignant granuloma was in infiltrative growth .The others had common appearances of malignancies.Conclusion CT signs are not characteristic in most cases compared with the common neoplasms. Surface configuration, bony change and circumstances are the main considerations in differentiate diagnosis and should be related to clinical and pathological materials..

Objective To assess and compare chemical and immunochemical fecal occult blood tests (FOBTs) in diagnosis of gastrointestinal hemorrhage and their clinical significance. Methods The FOBT was carried out in 4474 in-patients, out-patients or subjects who had annual physical examination using both hemoccult Ⅱ (CFOBT) and colloidal gold chromagraphy (IFOBT) methods.Those who was positive for FOBTs would be re-tested for 2 times and followed by gastroscopy and colonoscopy as well as other examinations in order to find the reason and location of gastrointestinal hemorrhage. Results FOBT was positive in 390 (8.22%) patients, of which 163 (41.8%) were detected by CFOBT, 100(25.6%) by IFOBT, and 127(32.6%) by both CFOBT and IFOBT. The clinical, endoscopic and other examinations revealed that upper and lower gastrointestinal bleeding were found in 235 (60.3%) and 136 (34.9%) patients, respectively. The detective rates of upper and lower gastrointestinal bleeding were 90.2% and 67.6% by CFOBT respectively, and 42.5% and 93.4% by IFOBT, respectively. The obvious gastrointestinal bleeding could be detected by both CFOBT and IFOBT. The diseases related to gastrointestinal bleeding involved acute gastric mucosal lesion, peptic ulcer, gastric cancer and colonic polyp,colorectal cancer and piles, etc. Conclusions It is demonstrated that FOBT is still important in screening and diagnosis of gastrointestinal hemorrhage.The CFOBT is superior to IFOBT in detecting upper gastrointestinal bleeding, whereas the IFOBT is superior to CFOBT in detecting lower gastrointestinal bleeding.