Objective To discuss the causes,agents and treatment of pancreatic encephalopathy in acute pancreatitis.Method We reviewed 26 cases of acute pancreatitis combined with pancreatic encephalopathy within recent 10 years.Results Pancreatic encephalopathy occurred always accompanied with such agents as hyperpyrexia, waterelectrolyte disturbance,hypoxemia, azotemia and bloodsugar disturbance etc.Conclusions The occurrence of the pancreatic encephalopathy is based on the harm that pancreatin does to the brain.The causes of pancreatic encephalopathy vary.To inhibit the releasing of pancreatin is the principle to prevent pancreatic encephalopathy, and to maintain normal physiological function,to control infection and nutritional support are the important links to prevent the pancreatic encephalopathy from happening.

Lung cancer is ranked the first among all malignant neoplastic diseases because of its high morbidity and mortality rate. Thus, lung cancer seriously threatens human health. More than 80%of lung cancer cases are non-small cell lung cancer (NSCLC). Unfortunately, the majority of NSCLC patients are already at the terminal stage of the disease when they seek medical attention. Such patients miss the optimal opportunity of surgery;thus, medical treatment becomes the main choice for them. Recently, molecular-target-ed therapy has made tremendous progress in clinical practice and provides a new potential treatment for patients at the terminal stage. In this review, the authors introduced some molecular-targeted therapeutic drugs to provide benefits for the individualized treatment of patients.

Objective:To evaluate the effect of management mode based on WeChat platform on patients with mild to moderate chronic obstructive pulmonary disease (COPD).Methods:A total of 100 patients with mild to moderate COPD treated in the outpatient or ward of the Respiratory Department of Shangqiu First People′s Hospital from January 2019 to January 2020 were included. According to the randomization criteria singular number (observation group, control group), there were 50 cases in each group. The control group received routine outpatient treatment and health education follow-up, the observation group was enrolled into the WeChat management group of COPD based on the same treatment as the control group. Smoking cessation, eight-item Morisky Medication Adherence Scale (MMAS-8) score for inhaled drug compliance, chronic obstructive pulmonary disease assessment test (CAT) questionnaire score, 6 min walking distance (6MWD) and lung function [forced expiratory volume in the first second (FEV 1) and FEV 1%pred] were compared between 2 groups before and after six months intervention. Results:After intervention, the intervention follow-up was completed in 46 patients in the observation group and 35 patients in the control group, the rate of loss to follow-up in the observation group was lower than that in the control group (8% vs. 30%) ( P<0.05); The success rate of smoking cessation, the score of MMAS-8, the score of CAT, the FEV 1 and FEV 1%pred in the observation group were higher than those in the control group [82.4% vs 53.6%, (5.17±1.06) vs (4.55±0.94) points, (6.72±4.29) vs (9.37±4.54) points, (1.87±0.44) vs (1.64±0.41) L, (69.48±10.97) vs (64.46±8.25)%] (all P<0.05). There was no significant difference in 6MWD between the observation group and the control group [(401.5±92.3) vs (382.9±79.7) m] ( P>0.05). Conclusion:Management intervention based on WeChat platform can improve the smoking cessation rate and medication compliance of patients with mild to moderate COPD, so as to reduce the symptoms of dyspnea and delay the decline of pulmonary function.

Objective:To analyze the relationship between hematological and genotype characteristics of fetuses and patients with hemoglobin (Hb) H disease and their natural disease progression.Methods:From 2010 to 2022, a total of 1 252 blood samples from fetuses and patients with Hb H disease who visited the Guangxi Zhuang Autonomous Regional Maternal and Child Health Hospital were collected (including 174 umbilical cord blood samples, 1 062 peripheral blood samples from patients over 2 years old, and 16 peripheral blood samples from patients with rare cases of genotype Hb H). Additionally, 278 peripheral blood samples were collected from patients aged 0 - 2 years old with Hb H 3.7, Hb H 4.2, Hb H CS, and Hb H WS disease for the study of trends in red blood cell development. Multiple probe hybridization and microarray comparative genomic hybridization technology combined with first-generation Sanger sequencing were used for rare mutation detection.Results:Among the 1 062 Hb H disease patients over 2 years old, 62.34% (662/1 062) had gene deletion (--/-α), of which Hb H 3.7 (-- SEA/-α 3.7) and Hb H 4.2 (-- SEA/-α 4.2) were the most common, accounting for 42.28% (449/1 062) and 19.11% (203/1 062) of the total, respectively. Among the non-deletion genotypes (--/αα T or α Tα/αα T), Hb H CS (-- SEA/α CS), Hb H WS (-- SEA/α WS) and α CSα/α CSα accounted for 16.85% (179/1 062), 16.48% (175/1 062) and 1.98% (21/1 062), respectively. The 81.12% (537/662) of patients with deletional Hb H disease showed mild to moderate anemia, with Hb H detection rates ranging from 75% to 80%. Among non-deletional Hb H disease, Hb H WS disease showed the mild (blood Hb concentration > 95 g/L in 90% of patients) phenotype while Hb H CS and Hb H QS (-- SEA/αα QS) patients had moderate to severe anemia, with Hb H detected in peripheral blood at higher levels than in other types of Hb H disease patients. Except for Hb H CS and Hb H QS, which did not show a significant increase in Hb A2 levels when complicated with β-thalassemia, Hb A2 levels were increased (> 3.5%) in all other types of Hb H disease patients. When Hb H disease was complicated with β-thalassemia, Hb H peaks were not detected in either type of Hb H disease. The results of red blood cell development trend detection showed that erythrocyte counts were elevated in patients with Hb H disease compared to their normal counterparts; whereas, blood Hb, mean erythrocyte volume (MCV) and mean erythrocyte hemoglobin content (MCH) were lower than in their normal counterparts ( P < 0.05) and decreased to the minimum at 6 months to 1 year of age. Patients with Hb H CS disease, as the most severe form of anemia, had the highest MCV values ( P < 0.001). The results of fetal cord blood with Hb H disease showed that α CSα/α CSα caused severe intrauterine anemia, followed by Hb H QS and Hb H CS. The content of Hb Bart's in umbilical cord blood was negatively correlated with the severity of anemia ( rs = - 0.58, P < 0.001). When Hb H disease was complicated with β-thalassemia, there was no significant improvement in fetal anemia, and the Hb Bart's content did not change significantly ( P > 0.05). In addition, Hb H 21.9 (-α 21.9kb/-- SEA) and Hb H 2.4 (-α 2.4/-- SEA) were common in patients with deletion rare Hb H. In patients with non-deletion rare Hb H, αα Amsterdam-A1/-- SEA and αα Hb G-Georgia/-- SEA were both first reported. Conclusions:There is heterogeneity in clinical manifestations of patients with different types of Hb H disease or same type of Hb H disease at different developmental stages. When patients with Hb H are complicated with β-thalassemia, the phenotype of patients with the deletion type is improved, while that of patients with the non-deletion type is not. Compared to normal individuals, patients with Hb H disease have lower blood Hb concentration, MCV and MCH, and more rapid physiological changes in red blood cells.

OBJECTIVE：To study the skin irritation and se nsitization of domestic generic drug Clobetasone butyrate cream ， and to compare it with commercial drug （original drugs ）. METHODS ：The skin irritation test was conducted on rabbits. Totally 24 rabbits were randomly divided into test preparation intact skin group ，test preparation abraded skin group ，commercial drug intact skin group and commercial drug abraded skin group ，with 6 rabbits in each group. 0.5 mL test preparation or commercial drug was administered to the left side of intact or abraded skin and the same amount of excipient on the right side of each rabbit twice a day for consecutive 7 days. The irritation of the drug to the rabbit skin was observed ，and the erythema and edema of the skin were scored；the skin of administration site was taken at 72 h after last administration and the end of 7 d after drug withdrawal for histopathological examination. The skin sensitization test （Buehler test ）was carried out on guinea pigs. Totally 60 guinea pigs were randomly divided into test preparation group （n＝20），commercial drug group （n＝20），positive control group （n＝10）and excipient control group （n＝10）. 0.2 mL test preparation or commercial drug was administrated to the left side of the rib abdomen skin of each guinea pig at the 0，7th，14th day to induce model ，and an equal amount of corresponding preparation was administered to the right side in the same way at the 28th day for stimulation. Hypersensitive response such as erythema and edema were observed and scored at 24 h and 48 h after the stimulation. The incidence of hypersensitive response was then calculated. RESULTS：In skin irritation test of rabbits ，no erythema and edema was caused by the test preparation or commercial drug on intact skin of rabbits ；scores of skin irritation was 0；there was no dermal irritation. Both test preparation and commercial drug caused transient slight erythema on abraded skin of a few rabbits ；scores of intact and abraded skin irritation were 0-0.33；there was no dermal irritation. There was no statistical significance among groups. No dermal pathological changes were observed. In skin sensitization test of guinea pig ，no hypersensitive response such as erythema and edema was found on the skin of guinea pigs in both test preparation and commercial drug groups ；both score and the incidence of hypersensitive response were 0. Compared with excipient control group ，there was no statistical significance of average score and the incidence of hypersensitive response in test preparation group and commercial drug group. CONCLU- SIONS：In skin irritation test of rabbits and skin sensitization test of guinea pigs ， the evaluation results of generic Clobetasone butyrate cream are the same as those of the original drug. It has no irritation to the skin of rabbit ，and no sensitization to the skin of guinea pigs.