Objective To select the optimal preparation technology of zucapsaicin cream and compare it with zuacta cream.Methods Cold stability,thermal stability,centrifugal stability,and appearance were used as indicators to select the ratio of prescription.In this study preparation technology was optimize by using orthogonal experiment method,and transdermal absorption of the homemade zucapsaicin cream and zucata cream were investigated by employing modified Franz diffusion pool.Results The optimized preparation technology was as follows,emulsifying temperature was maintained at 70 ℃,the stirring speed was set at 2 000 r·min-1,the main medicine was added into the oil phase,emulsifying time was 30 min.The results showed that there was no significant difference between the homemade zucapsaicin cream and the reference Zuacta cream.Conclusion The homemade zucapsaicin were tested to have reasonable ratio of prescription,stability,and definite transdermal effect,which was basically in accordance with zuacta cream.

Objective To evaluate effects of flush fluid of different temperatures on pain, comfort and adverse reactions in patients receiving choledochoscopy via T tube for residual bile duct stones. Methods Patients who underwent choledochoscopy were divided into the experimental group ( 36℃ saline was used as flush fluid) and control group ( room temperature saline was used as flush fluid) randomly. Pain degree, comfort degree, procedure time, the total amount of flush fluid, infusion speed and adverse reactions were recorded and analyzed. Results A total of 100 cases were included, 50 cases in each group. There was no significant difference between the two groups in their education level, working condition, operation methods, T-tube size, necessity for lithotripsy, procedure time, total amount of flush fluid and infusion speed (all P>0. 05). The pain scores were 1. 0(1. 00, 2. 00) and 2. 0(1. 00, 3. 25) (Z=-2. 158,P=0. 031) and the comfort scores were 6. 0(5. 00, 7. 25) and 5. 0(2. 00, 6. 00) (Z=-3. 384,P=0. 001) in the experimental group and the control group, respectively. There was significant difference in the change rate of heart rate during and before procedure between the two groups (-4. 07％± 10. 76％ VS 0. 30％± 10. 23％, P=0. 046) . The incidence of postoperative diarrhea in the experimental group and the control group was 6％( 3/50) and 22％ ( 11/50 ) , respectively (χ2=5. 316, P=0. 021 ) . Conclusion 36℃ saline flush can reduce pain scores, improve comfort degree and reduce the incidence of postoperative diarrhea after procedure in patients undergoing choledochoscopy via T tube.

Objective:To analyze the cardio-pulmonary ultrasound features of cardiogenic pulmonary edema (CPE) and pneumonia in adults with acute dyspnea, and to construct a differential diagnosis model.Methods:Seven hundred and forty-three patients with sudden acute dyspnea admitted to Hebei General Hospital from November 2018 to May 2022 were retropectively included. Ultrasonographer A performed lung ultrasound with 12 zone method, and interpreted and recorded the ultrasonic signs (including A-lines area, B-lines area, consolidation area and pleural effusion area) together with ultrasonographer B. According to the ultrasonic characteristics of the whole lung, it was divided into A-profile and B-profile. According to the continuity and symmetry of the distribution of B-lines in bilateral lung fields, it could be divided into bilateral lung continuous and discontinuous B-profile, bilateral lung symmetric and asymmetric B-profile. Left ventricular ejection fraction (LVEF), left ventricular filling pressure (E/e′), right ventricular dilatation, tricuspid annular systolic displacement (TAPSE) and inferior vena cava diameter (IVCD) were evaluated by echocardiography, and all the indexes were transformed into binary variables. According to the final clinical diagnosis and treatment results, the disease was divided into CPE group and pneumonia group. Binary Logistic regression model was used to screen independent influencing factors, and partial regression coefficient β value was used as a weight to assign a score, and a differential diagnosis model was established based on the total score. The predictive value of the model was evaluated by the receiver operating characteristic curve (ROC) and area under curve (AUC). After the model was built, 30 patients with CPE or pneumonia were independently collected by ultrasonographer C as external validation data, which were included in the model to draw ROC curve and evaluate the differential diagnosis efficiency of the model. The consistencies between ultrasonographer A and B, A and C in observing lung ultrasound were explored.Results:A total of 743 patients from 43 clinical departments were included, including 246 cases in CPE group and 497 cases in pneumonia group. Multivariate logistic regression analysis showed that bilateral lung continuous B-profile, bilateral lung symmetric B-profile, ≥1 pleural effusion area, LVEF<50%, E/e′>14 were the risk factors for CPE (all OR>1, P<0.05), and ≥1 consolidation area and ≥1 pleural sliding disappearance area were the protective factors for CPE (all OR>1, P<0.05). The sensitivity, specificity and AUC of combined cardio-pulmonary ultrasound index β value weight score in the differential diagnosis of CPE and pneumonia were 0.939, 0.956 and 0.986, respectively. The AUC of external validation data was 0.904. Ultrasonographer A and B, A and C had good consistency in the interpretation of lung ultrasound signs ( P<0.05). Conclusions:The differential diagnosis model based on combined cardio-pulmonary ultrasound indexes has high differential diagnosis efficiency for CPE and pneumonia, and can be used in bedside cardio-pulmonary ultrasound practice.