Objective:To discuss the value of fetal malformations by nasal bone measurement with Ultrasound.Methods:Retrospective diagnostic analysis of ultrasound data of the five years, 41 cases of Down syndrome (DS) with pathological and chromosomal diagnosis, with double-blind method by two experienced deputy chief physician, statistical analysis by spss17.0, used the linear regression equation to describe the relationship of the nasal bone and ultrasound gestational age.Results: Normal fetal nasal bone length increased with increasing maternal gestational age, the nasal bone with ultrasound gestational age regression equation Y=0.238 +0.0246 X, F=78.65, fetal nasal bone length and gestational age were both straight-line linear correlation (r=0.801,P=0.038), with a statistically significant (P<0.05).Nasal bone was short in the corresponding gestational age and the healthy control group, 11-14-week (t=-5.378,P=0.000), 15-18 weeks (t=-2.369,P=0.029),19-22 weeks (t=-2.195,P=0.042), significant differences in the results, with a statistically significant (P<0.05).Conclusion: Scanning the fetal nasal bone in prenatal screening, accurately grasp the specific section, can find the abnormal development of the nasal bone. The developmental of nasal bone can effective response to the gestational age of the fetus; comprehensive ultrasound screening can effectively diagnose the fetal malformations.

Objective:To observe the clinical effect and safety of desloratadine citrate disodium in the treatment of allergic rhinitis ( AR) . Methods:Totally 80 patients were randomly divided into the control group and the observation group with 40 ones in each. There was no difference in gender, age, duration of allergic rhinitis, classification of serological specificity IgE between the two groups (P>0. 05). The observation group was treated with desloratadine citrate disodium tablets 8. 8mg, po, qd. The control group was given loratadine 10mg, po, qd. The treatment course was 12 days. All the patients were not given corticosteroids and other antihistamines. The clinical symptoms and signs integral, curative effect and adverse drug reactions during the treatment were observed. Results: In the observation group, 23 cases were markedly effective, 13 cases were effective, 3 cases were ineffective, one case didn’ t finish the study, and the total effective rate was 92. 30%. In the control group, the above index was 10 cases, 18 cases, 10 cases, 2 cases and 73. 68%, respectively. There was statistically significant difference in the total effective rate between the two groups (P<0. 05). The symptoms and signs integral after the treatment in the observation group was significantly decreased compared with that in the control group, and the difference was statistically significant (P<0. 05). The incidence of adverse drug reactions in the observed group was obviously lower than that in the control group. Conclusion:Compared with that of loratadine, the clinical efficacy of desloratadine cit-rate disodium tablets is better in the treatment of AR with good safety.

Objective:To prepare minocycline hydrochloride sustained release tablets and optimize the formula .Methods: The method of dry granulation tabletting was used to prepare minocycline hydrochloride sustained release tablets .With the cumulative re-lease rate in 1, 2, 4 and 8 h as the index, the amount of HPMC E50 and HPMC K100LV was studied by central composite design re-sponse surface methodology .The in vitro release similarity of the sustained-release tablets and the reference tablets was compared .Re-sults:The optimized formula contained 35 mg HPMC E50 and 70 mg HPMC K100LV.The f2 for the sustained release tablets and the reference tablets in the different dissolution media was 79.06, 84.62, 75.46 and 72.95, respectively.Conclusion: Minocycline hydrochloride sustained release tablets with the formula optimized by central composite design response surface methodology meet the requirements.The results can provide evidence for the next industrial production .

Objective: To observe the clinical efficacy of moving cupping on the back for patients with chronic fatigue syndrome (CFS)-related sleep disorders. Methods: A total of 60 patients with CFS-related sleep disorders were randomized into a control group and an observation group, with 30 cases in each group. The control group was treated with oral administration of fluoxetine hydrochloride capsule. The observation group was treated with moving cupping on the back, once every other day. The efficacy was observed after 4 weeks of treatment. The fatigue scale-14 (FS-14) and Pittsburgh sleep quality index (PSQI) were assessed before and after the treatment to evaluate the clinical efficacy. Results: The total effective rate was 93.3％ in the observation group, and 73.3％ in the control group. The difference between the two groups was statistically significant (P<0.05). After treatment, the improvement of physical fatigue value, mental fatigue value, and the total score of FS-14 in the observation group were statistically different from those in the control group (all P<0.05). The scores of subjective sleep quality, sleep latency, habitual sleep efficiency, use of sleeping medication, daytime dysfunction of PSQI and the total score in the observation group were improved more significantly than those in the control group (all P<0.05). Conclusion: Moving cupping on the back can significantly improve sleep disorders in CFS patients, and it has a better curative effect than oral fluoxetine hydrochloride capsules.

Objective To explore the changes and clinical significance of serum human cartilage glycoprotein-39(HC gP39),osteopontin (OPN) and rheumatoid factor (RF) in patients with rheumatoid arthritis (RA).Methods Serum HC gP39,OPN levels were measured by ELISA in 98 patients with RA and 98 healthy controls.Serum RF was detected by nephelometric immunoassay.Results The serum HC gP39,OPN and RF levels of RA group were significantly higher than the healthy control group (t =20.25,32.71,36.34,all P ＜ 0.01),and serum HC gP39,OPN and RF levels in active phase patients were higher than the inactive phase patients (t =24.22,45.62,50.15,all P ＜0.01).The levels of serum HC gP39,OPN increased gradually with the increase of the staging severity(F =18.48,12.36,all P ＜0.05).The serum level of RF was positively correlated with the levels of HC gP39,OPN in patients with RA (r =0.682,0.656,all P ＜ 0.01),the serum level of HC gP39 was positively correlated with the level of OPN (r =0.608,P ＜ 0.01).Conclusion The HC gP39,OPN and RF reflect situation of RA patients and have close relationship with the clinical progression of RA,which can be used as one of important indexes to judge RA activity and different staging.

The clinical probation is an important part of medical education, which is also a bridge from theoretical learning to clinic practice. To improve the quality of clinical probation teaching of hematology department, multiple teaching activities have been carried out, including full preparation before teaching, creating better medical environment, arousing enthusiasm, tralning the physician-patient communication ability and strengthening operating skill of the students. Good study effect has been achieved.

Objective To explore clinical characteristics and treatment of the thrombotic microangiopathy (TMA) induced by malignant hypertension, and provide a better understanding of the disease. Methods The clinical manifestations, laboratory examinations, therapeutic methods and prognosis of 15 TMA patients induced by malignant hypertension were analyzed retrospectively. Results The clinical manifestations were characterized by microangiopathic hemolytic anemia, thrombocytopenia and kidney injury. None of the patients required plasma exchange therapy. After antihypertensive treatment, all of 15 patients were discharged with improved clinical condition, remoglobin levels and platelet count. Conclusions The TMA induced by malignant hypertension is different from the classic TMA. Improving the understanding of TMA induced by malignant hypertension will contribute to early diagnosis and targeted treatment.

Objective: To evaluate the clinical efficacy and safety of ticagrelor in the patients with acute coronary syndrome ( ACS) . Methods:A retrospective study was applied to investigate the ACS patients treated with ticagrelor in our hospital from July to December in 2015. The basic information of patients, drug administration, platelet aggregation induced by ADP, major adverse cardio-vascular events ( cardiac death,nonfatal myocardial infarction,target vessel revascularization and stent thrombosis) , and adverse drug reactions ( ADR) were recorded. The incidence of end point events was calculated and the change of platelet aggregation induced by ADP before and after the drug administration was analyzed by SPSS statistical software. Results:A total of 161 patients were collected. The incidence of cardiovascular adverse events was 1. 2%, while the incidence of adverse drug reactions was 30. 4% including bleeding (15. 5%) without severe bleeding events and dyspnea (10. 6%) with 3 severe ones. The platelet aggregation rate before and after the ticagrelor treatment respectively was (54. 96 ± 14. 654)%and(24. 37 ± 13. 183)% in 122 patients with low reaction to clopidogrel( P<0. 01). Conclusion:Ticagrelor at the recommended dose can further reduce the platelet aggregation induced by ADP. In spite of high incidence of ADR, ticagrelor has slight ADR with good tolerance.

Objective Serum abnormal prothrombin (PIVKA-Ⅱ) level was detected in pancreatic cancer patients and its clinical value in diagnosing and treating pancreatic cancer was explored.Methods A total of 112 pancreatic cancer patients,28 benign pancreatic diseases patients and 79 healthy controls were collected from Cancer Hospital of Hubei Province.Serum PIVKA-Ⅱ level was determined by chemiluminescent immunoassay (CLIA).CEA and CA19-9 level was detected by electrochemiluminescence immunoassay (ECLIA).Receiver operation characteristic (ROC) curve was drawn and the cut-off value was set.The sensitivity,specificity and accuracy were calculated.Results PIVKA-Ⅱ level in 112 pancreatic cancer patients was 39.0 (22.61,137.67)U/L[median (quartile range)],which was significantly higher than that in 30 patients with benign pancreatic disease [23.0 (17.32,29.67) U/L] and 79 healthy controls [21.21 (17.9,25.12) U/L].The differences were statistically significant (P＜0.01).However,there was no significant difference between benign pancreatic disease patients and healthy controls.ROC analysis showed that area under curve(AUC) for PIVKA-Ⅱ,CEA and CA19-9 was 0.793,0.707 and 0.849.The cut-off value for discriminating pancreatic cancer was established at 32.4,4.7 and 27.0 U/L for PIVKA-Ⅱ,CEA and CA19-9.The sensitivity was 61.6％,38.0％ and 66.1％,and the specificity was 86.3％,96.3％ and 89.9％,and the accuracy was 71.7％,62.3％ and 75.0％,respectively.The sensitivity,specificity and accuracy of PIVKA-Ⅱ combined with CEA and CA19-9 was 90.2％,76.0％ and 84.3％.The sensitivity was obviously higher,while the specificity was lower.Serum PIVKA-Ⅱ level was associated with advanced tumor stage.There were 20 patients who were followed up.PIVKA-Ⅱ level in 15 cases were decreased after surgery or interventional therapy (50.6 U/L vs 110.5 U/L,P ＜0.001),which was increased in 4 of the five cases who received palliative care to a various degree.Conclusions PIVKA-Ⅱ detection could benefit the diagnosis and prognosis monitoring of pancreatic cancer.

The Pareto effect generated in use of journal articles covered in Wiley Online Library ( WOL) , a full-text database developed by China Pharmaceutical University, was analyzed, which showed that the number of WOL-covered source journals in ACIE, SSCI, A & HCI, the number of full-text journals that published SCI-covered papers of our university, the key and strong subjects of our university were the leading factors of Pareto effect gener-ated in use of WOL, studies on Pareto effect are thus of importance for the library in its development of literature resources, data information service and subject service.