Idiopathic hypogonadotropic hypogonadism(IHH) is a complex oligogenic disease.About 60％ of patients are associated with anosmia or hyposmia,also known as Kallmann syndrome. Based on genetic and molecular biological research,about more than ten IHH responsible genes have been discovered.

Objective: To retrospectively analyze the efficacy and safety of three high-dose opioids in the treatment of cancer pain in our hospital.Methods: The medical records of 73 patients with severe cancer pain were collected, and according to the taken drugs, they were divided into group A (sustained-release morphine tablets, 25 ones), group B (sustained-release oxycodone tablets, 36 ones) and group C (transdermal fentanyl, 12 ones).Evaluation of patients with average of pain NRS,breakthough pain NRS,dosage of opioids,quality of life on admission and in 24h after the 4 weeks treatment;In addition,the other analgesic medications,auxiliary medicines,and adverse drug reations were recorded at the same time.Results: The NRS was significantly lowed in the three groups after the 4-week treatment (P＜0.01), and that in group B was lowest with notable difference when compared with that in group A (P＜0.05).The number of breakthrough pain also significantly decreased in the three groups after the treatment (P＜0.01), and there was no significant difference among them (P＞0.05).The doses of opioids analgesics after the 4-week treatment were significantly higher than those on admission (P＜0.01), and the doses in group B were slightly lower than those in the other two groups, while there was no significant difference among them (P＞0.05).The quality of life in the three groups was improved significantly after the treatment (P＜0.01), and no significant difference was shown among them (P＞0.05).The other pain medications and auxiliary medicines used in the three groups were similar (P＞0.05).The incidence of adverse reactions in the three groups had no significant difference (P＞0.05).Conclusion: The standardization of the three high-dose opioids analgesics can control pain effectively and improve the quality of life, which is worthy of clinical promotion.In addition, oxycodone shows the best analgesic effect, whiel fentanyl transdermal patches have the lowest incidence of adverse reactions.

Objective To investigate and analyze the application of three steps therapy analgesics in good pain management(GPM)-ward,in order to provide rational analgesics drug application in clinical practice.Methods Through the hospital HIS system,the application data of analgesics in GPM-ward from Jan.2014 to Dec.2015 were collected and analyzed.Results The sum and proportion of the strong opioid drug was lined first.The total DDDs of the three -stage analgesics ranked from high to low was celecoxib >tramadol >oxycontin >morphine >fentanyl trans-dermal.The celecoxib was usually assisted the other;in addition,tramadol's DDDs and expense amount decreased, which was in the line with NCCN guidelines.Moreover,oxycontin's DDDs and expense amount increased.As well as, anesthesia prescription qualified rate was 93.5%,medical record standard rate was 80.5% in 2014,prescription qual-ified rate was rose to 97.5%,medical record standard rate was rose to 91.5% in 2015.Conclusion The application of cancer pain drug was basically rational in GPM-ward,which is in line with the principles of cancer pain relief by the mouth,by the clock,by the ladder and for the individual.

Objective To investigate the clinical effects of the treatment of cancer pain control by the partic-ipation of pharmacist,and the effect on cancer patients and families mental state and quality of life.Methods Clini-cal pharmacists took participate in the standardized treatment of pain,before and after different intervention,NRS scale was used to assess the patients'pain,self -rating anxiety scale(SAS)and self -rating depression scale(SDS)were used to assess the patients and families'psychological mental status.SF -36 scale was used to assess the quality of life.Results Compared with pre -intervention,two weeks later,the overall situation of patients with pain was signifi-cantly improved[NRS score (4.72 ±1.13)points vs.(3.57 ±0.97)points,t =7.722,P <0.01].Patients and their families,anxiety and depression significantly alleviated [patients:SAS (32.56 ±4.66 )points vs.(60.31 ± 4.27)points,t =38.180,P <0.01,SDS (45.89 ±5.46)points vs.(68.34 ±6.23)points,t =28.250,P <0.01;families:SAS(33.76 ±4.82)points vs.(50.31 ±6.47)points,t =15.593,P <0.01,SDS (32.89 ±3.54)points vs. (52.34 ±6.23)points,t =15.593,P <0.01 ].At the same time,the patients and families'quality of life were improved.Conclusion Clinical pharmaceutical care can relieve the body pain,meanwhile,those could effectively relieve the anxiety,depression and other negative psychology of cancer patients and families,improve the whole quality of life.

Objective: To observe the influence of epidermal growth factor tyrosine kinase inhibitors (EGFR-TKIs) on peripheral blood T lymphocyte subsets, and its efficacy and safety in the treatment of non-small cell lung cancer (NSCLC) patients.Methods: A total of 35 cases with NSCLC in our hospital were selected as the observation group and 28 healthy persons undergoing health examination at the same time were used as the control group.All the NSCLC patients were with EGFR mutations and accepted the EGFR-TKIs therapy.Flow cytometry was employed to detect T lymphocyte subsets in peripherial blood (including CD3+,CD4+,CD8+,CD4+/CD8+ and NK lymphocy-tes)in one week before the treatment, at the 1st, 2nd and 4th cycle after the EGFR-TKIs treatment, and the curative effect and safety were evaluated as well.Results: Before the chemotherapy, the levels of CD3+, CD4+, CD4+/CD8+ and NK lymphocytes in the NSCLC patients were significantly lower than those in the control group (P<0.01), and CD8+ lymphocytes increased significantly (P<0.01).After the treatment of 1, 2 and 4 cycles, the levels of CD4+and CD4+/CD8+ increased in varying degrees when compared with those before the treatment (P<0.01), and CD8+ decreased significantly when compared with that before the treatment (P<0.01).After the treatment of 2 and 4 cycles, NK cells increased in varying degrees when compared with those before the treatment (P<0.05).After the treatment of 4 cycles, the level of CD3+lymphocytes was significantly higher than that before the treatment (P<0.05).The T lymphocyte immune function in the patients with different therapeutic effects showed statistically significant difference (P<0.05).The order of lymphocyte subgroup improvement was PR>SD>PD.The adverse reactions caused by EGFR-TKIs were slight, and all could be improved markedly after the symptomatic treatment.Conclusion: EGFR-TKIs can significantly regulate the expression of T lymphocyte subsets in NSCLC patients and improve the immune function of the patients with promising safety.

Objective21 -hydroxylase deficiency ( 21-OHD) patients are at high risk of developing metabolic syndrome.Low dose of glucocorticoid is crucial in the treatment.This study is to investigate the effect of glucocorticoid therapy on potential metabolic disorders.Methods Thirty-two treated and 31 untreated 21-OHD patients were recruited.The components of metabolic syndrome were investigated in both groups.Results Serum testosterone [ (0.61 ±0.12 vs 4.10±0.66) ng/ml,P＜0.01 ],17-(OH) progesterone[ 17-OHP,( 14.83±3.48 vs 48.52±4.72 )ng/ml,P＜0.01 ],dehydroepiandrosterone sulfate[ DHEAS,(55.7±23.6 vs 405.2±65.7 ) μg/dl,P＜0.01 ],and ACTH[ ( 105.8±44.7 vs 617.4± 163.3 ) pg/ml,P＜0.01 ] levels were significantly reduced,whereas body mass index [ ( 23.2±0.9 vs 21.1 ±0.5 ) kg/mz,P＜0.05 ],systolic blood pressure [ ( 120.5 ± 1.3 vs 115.5 ± 1.8 ) mm Hg,P＜0.05,1 mm Hg =0.133 kPa ],serum triglyceride [ ( 1.8±0.2 vs 1.1 ±0.1 ) mmol/L,P＜0.05 ],and homeostasis model assessment for insulin resistance [ HOMA-IR,( 2.07 ± 0.27 vs 1.16 ± 0.12 ),P ＜ 0.01 ] were markedly increased in glucocorticoid treated group.Multivariates regression analysis showed that body mass index was the most important risk factor for HOMA-IR.The correlation of glucocorticoid replacement and HOMA-IR was not observed after adjustment of age and body mass index.ConclusionGlucocorticoid treatment increases body weights,which leads to insulin resistance and metabolic disorders for 21-OHD patients.More attention should be paid to control BMI and metabolic disturbances in 21-OHD patients.