Objective To explore the combination clinical effects of salbutamol and budesonide on bronchial asthma .Methods 120 patients withbronchial asthma in First People's Hospital of Yuhang District were selected and randomly divided into two groups of control group and experimental group with 60 cases in each group.Patients in the control group was treated monotherapy with salbutamol, patients in the experimental group were given albuterol and budesonide combination therapy.The treatment effect on symptoms and lung function of the two groups were compared after two weeks . Results After treatment, the breathing, wheezing sound, gasp and cough remission time were significantly shorter in the experimental group than in the control group,the difference was statistically significant ( P <0.05 ) .The effective rate of the control group was 78.33%, the effective rate of the experimental group was 95.00%,the difference was statistically significant(P<0.05).The improvement of lung function in the experimental group was significantly higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion Compared with monotherapy, the combination of salbutamol and budesonide can improve the efficacy of bronchial asthma patients and improve the quality of life of patients .

OBJECTIVE:To investigate the role of clinical pharmacists in the therapy for sever acute pancreatitis induced by hy-perlipidemia(HL-SAP)patient. METHODS:Clinical pharmacists participated in the therapy for a pregnant patient with HL-SAP af-ter cesarean section,assisted physicians to optimize therapy plan through analyzing the disease condition according clinical guide and relevant literatures. Clinical pharmacists suggested to decrease atorvastatin 20 mg,qd to 10 mg,qd in order to avoid the risk of rhabdomyolysis and liver injury. When patient’s hemogram kept stable and infection had been controlled,clinical pharmacists suggested antibiotics de-escalation treatment:Levofloxacin injection 0.5 g,ivgtt,qd+Metronidazole injection 0.5 g,ivgtt,q12 h in-stead of meropenem. RESULTS:Physicians adopted the suggestions of clinical pharmacists. The patient was recovered and transfer to gastroenterology department 15 d later. CONCLUSIONS:Clinical pharmacists provide pharmaceutical care for HL-SAP patient after cesarean section,and assist physicians to formulate therapy plan so as to reduce the incidence of ADR effectively and guaran-tee the safe and effective use of drugs.

Castleman disease (CD) is a rare polyclonal lymphoproliferative disorder characterized by enlarged hyperplastic lymph node(s). Unicentric Castleman disease (UCD) is an indolent condition often treated by local approaches. On the contrary, pa-tients with multicentric Castleman disease (MCD) have less favorable prognoses and require systemic treatments. Cytotoxic chemother-apy has been widely used to treat MCD with varying degrees of response because of the toxicity risk of the treatment. The pathogenesis remains unknown;however, most pieces of evidence to date point toward human herpes virus 8 (HHV-8) and deregulated overproduc-tion of interleukin (IL-6). Discovery of putative etiologic factors and targets in MCD, particularly HHV-8, CD20, and IL-6, has translat-ed to the use of rituximab, anti-IL-6-based, and antiviral therapy. Good results have been realized through targeting HHV-8 replication, CD20, and IL-6 pathways. In this article, we reviewed the classification, pathogenesis, and current treatments of CD and provided in-sights into future treatment strategies based on disease biology.

Objective To study the relationship between the T helper cells (Th22)/interleukin (IL)-22 and rheumatoid arthritis (RA) with interstitial lung disease (ILD), and to define the clinical significance of Th22 cells for RA. Methods The quantity of Th22 cells in the peripheral blood from 40 patients with RA (20 RA with ILD, 20 RA without ILD) were examined by flow cytometry, the level of IL-22 in the sera was detected by enzyme-linked immunosorbent assay (ELISA). Comparisons between groups were analyzed by t-test, rank sum test, and the correlation of parameters were tested by linear correlation analysis. Results The quantities of CD4+IL-22+ cells (Th22) in RA patients [(0.15 ±0.07)%] were significantly higher than normal controls [(0.09 ±0.05)%] (t=4.097, P<0.01), and IL-22 levels in RA patients [(83 ±7) ng/L] were significantly higher than normal controls [(61±5) ng/L] (t=13.057, P<0.01). The quantities of Th22 cells in RA-ILD patients [(0.18±0.07)%] were significantly higher than RA-NILD patients [(0.13±0.05)%] (t=2.919, P=0.008), and IL-22 levels in RA-ILD patients [(87±6) ng/L] were significantly higher than RA-NILD patients [(80±6)ng/L] (t=3.624, P=0.001). The quantities of Th22 cells were positively correlated with erythrocyte sedimentation rate (ESR), rheumatoid factor(RF) and 1.4 disease activity score (DAS)28 (r=0.336, 0.377, 0.577, P<0.05),and the level of IL-22 were also positively correlated with ESR and DAS28 (r=0.406, 0.576, P<0.05). Conclusion The quantities of Th22 cells and IL-22 level are increased in RA patients, especially in RA-ILD patients. The quantities of Th22 cells and IL-22 level are positively correlated with ESR and DAS28. It may play a certain role in RA especially in RA with ILD.

Objective To compare the efficacy and adverse reaction of teniposide (VM-26) plus carboplatin (TC regimen) and etoposide (VP-16) plus carboplatin (EC regimen) in treatment of newly diagnosed small cell lung cancer (SCLC), and the possible role of VM-26 on prevention of brain metastasis of SCLC. Methods A total of 102 previously untreated SCLC patients without brain metastasis were divided into VP-16 group received EC regimen (n=64) and VM-26 group received TC regimen(n=38). The carboplatin dosages in two groups were calculated by blood concentration-area under the curve(AUC)=5, and intravenous infusion of 1 h for the first day. In VM-26 group, VM-26 70 mg/m2+normal saline 500 mL was intravenously infused of 2 h for 1-3 days. VP-16 100 mg/m2+normal saline 500 mL was given to VP-16 group, 1 h for 1-3 days. Twenty-one day was for 1 treatment cycle. The curative effect, prognosis and adverse reaction were compared between two groups. Results The overall response rates (ORR) and disease control rates (DCR) were 78.9%(30/38) and 97.4%(37/38) in VM-26 group, respectively, and 76.6%(49/64) and 95.3%(61/64) in VP-16 group, respectively, with no significant differences between the two groups (χ2=0.078 and 0.283, P<0.05). The median progression-free survival (PFS) was 10 months (95%CI 7.4-12.6) in VM-26 group and 9 months (95%CI 6.4-11.6) in VP-16 group (χ2=0.029,P=0.866). The median overall survival (OS) was 18 months (95%CI 16.5-19.5) and 16 months (95%CI 9.9-22.1) in VM-26 group and VP-16 group (χ2=0.217,P=0.642), respectively. The survival rates for 1,2 and 3 years were 73.7%, 36.8%and 18.4%in VM-26 group, and 71.9%, 37.5%and 18.8%in VP-16 group, respectively, with no significant differences between the two groups (P>0.05). The brain metastasis rate was significantly higher in VP-16 group [43.8%(28/64)] than that of VP-26 group [21.1%(8/38),χ2=5.379,P=0.02). The adverse reactions were mainly grade 1/2 bone marrow suppression in two groups. Conclusion TC is a highly active regimen for treatment of SCLC. There is no difference in the ef?fectiveness and adverse reactions versus EC. Application of VM-26 can reduce the incidence of brain metastasis in SCLC patients.

As one of members of the Notch gene family , Notch-1 signaling pathway plays an important role in the processing of cell proliferation , differentiation , survival and apoptosis .The abnormal expression of Notch-1 is closely related to tumorigenesis and de-velopment .In recent years , many studies have focused on the relationship between the Notch-1 signaling pathway and tumor .This arti-cle reviews the achievement of Notch-1 signaling pathway in recent tumor researches .

Objective To compare the therapeutic efficacy of reteplase(r-PA) and alteplase(t-PA) in the high risk patients with pulmonary embolism during a pulmonary artery catheter broken bolt in the interventional treatment,and to evaluate the clinical safety.Methods 54 high risk patients were selected as the research subjects,and they were randomly divided into treatment group(24 patients) and control group(30 patients).Patients in both two groups were given general treatment,low molecular heparin sodium anticoagulation therapy.Besides,the control group was given local perfusion thrombolysis enzyme treatment.While the treatment group was given local perfusion at enzyme thrombolysis treatment.Results Two-way Chi-square test results showed that before treatment,there were no significant differences in HR,RF,PaO2,PaCO2 and SaO2 between the two groups(all P>0.05).After 3-day treatment,in the treatment group,HR[(83.39±14.25)times/min],RF[(17.80±1.65)times/min],PaO2[(87.59±7.34)mmHg],PaCO2[(37.60±7.62)mmHg],SaO2[(97.29±6.72)%] in the treatment group group,which in the control group were (97.7±15.51)times/min,(20.49±1.68)times/min,(81.53±6.42)mmHg,(35.69±4.57)mmHg,(93.91±3.27)%,the differences between the two groups were statistically significant(t=8.01,7.33,6.32,all P<0.05).After three days therapy,the total effective rate was 86.67% in the treatment group,which was significantly higher than 75.00% in the control group (x2=1.21,P=0.55).After thrombolysis treatment,there was no significant difference between the treatment group and control group in hemorrhage rate(x2=2.24,P=0.53),which were 13.33% and 12.50%,respectively.Besides,the hemorrhage patients were all got effectively treated and their condition was significantly improved,and none of them occurred severe bleeding during the observation periods in the two groups.Conclusion Local perfusion reteplase therapy in high-risk patients with PE through the pulmonary artery catheter broken bolt in the interventional treatment is safe and is worthy of clinical promotion.

OBJECTIVE:To study the pharmacokinetics of lidocaine and bupivacaine in children undergoing epidural anesthesia so as to evaluate the safety and efficacy of this anesthetic method.METHODS:A total of 30 children who were expected to undergo surgery for undescended testis,hernia or high ligature for hydrocele were assigned to receive 2% lidocaine(5 mg?kg-1) plus 0.75% bupivacaine(1.875 mg?kg-1)(single epidural dose) by epidural anesthesia.Plasma concentrations of lidocaine and bupivacaine were determined by HPLC.Pharmacokinetics parameters were calculated and fitted by using DAS ver 2.0 pharmacokinetic program.RESULTS:The plasma concentration-time curves of lidocaine and bupivacaine were in line with a two-compartment model.The main pharmacokinetic parameters of lidocaine vs.bupivacaine were as follows:tmax 27.0 vs.33.0 min;t1/2? 43.97 min vs.73.52 min;Cmax 2.411 mg?L-1 vs.1.475 mg?L-1;AUC0～∞ 144.714 mg?min?L-1 vs.168.541 mg?min?L-1.CONCLUSION:The dosages of the local anesthetics injected into the epidural cavity of children are proven to be safe and effective.

Objective To study the possibility of fetal cardiac rhabdomyoma diagnosed by ultrasonography,and the relationship between the fetal cardiac rhabdomyoma and family tuberous sclerosis. Methods High resolution ultrasonic equipment with fetal cardiac software was used. The main cross section of four chamber view was studied mainly. The location, the number of the tumor and the outflow tract of left and right ventricular cordis were scanned carefully, the maternal abdominal scan was performed as well. Results Five cases of fetal cardiac rhabdomyoma were found by routine prenatal ultrasonography, and were confirmed by autopsy. Among them, one case were associated with maternal tuberous sclerosis. Conclusions Fetal cardiac rhabdomyoma associated with tuberous sclerosis. Fetus with cardiac rhabdomyoma frequently die of cardiac failure; since the prognosis of the tuberous sclerosis with neural sclerosis was very poor, when the fetal cardiac rhabdomyoma was detected prenatally, the possibility of tuberous sclerosis should be considered, also relative examination must be performed to the mother to decrease the perinatal mortality.

Objective To improve the diagnosis of amniotic bands syndrome with ultrasound. Methods All pregnant women underwent ultrasonographic examination to observe the intra amniotic band like structures. Results Among 8771 women undergone ultrasound examination, 60 were found with intra amniotic band structure. Seven cases were diagnosed as amniotic bands syndrome and 53 intra amniotic band like structures included extra amniotic pregnancy(7), amniotic sheets(4), incomplete uterine septum(24), fetal nuchal cystic hygroma(2), fetal nuchal and trunk edema(11) and disclosed extra embryo sac(5). Conclusions Not all the intra amniotic band like structures is amniotic band. But any abnormal structures detected in early stage should be closely followed up.