Objective To study the clinical significance of lung function and allergen detection in the diagnosis of cough variant asthma (CVA) in children. Method Forty-three cases of chronic cough in children with bronchial provocation (diastolic) test and skin prick allergy test results were analyzed, CVA group was 23 cases and control group was 20 cases. Results The positive of bronchial provocation (diastolic) test in CVA group was 19 cases, significantly higher than that in control group (3 cases, χ2=14.745, P ＜ 0.01 ).The positive of skin prick allergy test in CVA group was 17 cases , significantly higher than that in control group (5 cases, χ2 = 10.243,P ＜0.05). The correlation analysis showed that bronchial provocation (diastolic) test and skin prick allergy test was significantly correlated (r =0.404,P＜0.01 ).Conclusion Bronchial provocation (diastolic) test has an important role in the diagnosis of CVA; skin prick allergy test has a supporting role on the CVA diagnosis;allergens affect on lung function, bronchial provocation (diastolic) test with the help of skin prick allergy test in children with cough variant asthma diagnosis.

OBJECTIVE To mine the adverse drug events （ADE） signals for gilteritinib， and provide a reference for safe drug use in clinic. METHODS ADE reports with gilteritinib as the primary suspected drug were extracted from the FDA Adverse Event Reporting System （FAERS） database from February 1st， 2018 to December 31st， 2023. Reporting odds ratio （ROR） and proportional reporting ratio （PRR） were applied to detect the risk signals from the data in the FAERS database. The classification and statistics of collected signal data were conducted by using the preferred term （PT） and systemic organ class （SOC） in ADE terminology set of the Medical Dictionary for Regulatory Activities （24.1 edition）. RESULTS Totally， 2 755 gilteritinib-related ADE reports were collected from the database， involving 676 ADE signals （95 positive signals）， 313 PTs and 25 SOCs. Among them， nine signals were not recorded in the package insert. The top 5 PTs consisted of abnormal liver function， decreased platelet count， febrile neutropenia， pneumonia and myelosuppression. The top 6 SOCs for positive signal counts were examinations， general disorders and administration site conditions， respiratory， thoracic and mediastinal disorders， infections and infestations， heart organ disorders， and nervous system disorders. ADEs not recorded in the drug package insert included pneumonia， myelosuppression， decreased blood cell count， sepsis， hemorrhage， infection （not specifically referred to）， septic shock， respiratory failure， and aspergillosis. CONCLUSIONS In addition to paying attention to common ADEs such as liver dysfunction and thrombocytopenia， it is necessary to monitor ADEs with strong signals that are not mentioned in the drug instructions when using gefitinib， such as pneumonia， bone marrow suppression， cytopenia， sepsis， bleeding， infection （not specifically referred to）， septic shock， respiratory failure， Aspergillus infection， elevated serum creatinine and interstitial lung disease.

OBJECTIVE To investigate the present equipment and management situation of narcotic drugs in primary healthcare institutions from Qiandongnan prefecture of Guizhou province. METHODS The questionnaire survey was conducted among pharmacy department heads and medical staff from primary healthcare institutions in Qiandongnan prefecture of Guizhou province. Descriptive statistical analysis was conducted on the survey results. RESULTS Of 251 healthcare institutions in this survey， 29 healthcare institutions were equipped with narcotic drugs， accounting for 11.55%. The reasons for the narcotic drugs unequipped were mainly as follows: insufficient attention， no storage conditions for narcotic drugs， complex program of narcotic drug management， small amount usage and so on. Among the 29 primary healthcare institutions equipped with narcotic drugs， all of them did not monitor patient usage， accounting for 100%； 29 healthcare institutions did not implement a return visit or follow-up every 3 months， accounting for 100%. CONCLUSIONS The health administration departments should strengthen the administration of narcotic drugs in primary healthcare institutions. At the same time， training on standardized management and clinical rational application of narcotic drugs for medical staff in primary healthcare institutions should be enhanced by the health administrative department.

Objective:To study the effects of new antiepileptic drugs (AEDs), including Topiramate (TPM), Oxcarbazepine(OXC), Lamotrigine(LTG), and Levetiracetam (LEV) monotherapy on bone metabolism in children with epilepsy aged 4-12.Method:s One hundred and sixty children with epilepsy who were diagnosed for the first time at Shanxi Children′s Hospital from July 2016 to June 2017 were selected and given oral TPM (40 cases), OXC (40 cases), LTG (40 cases) and LEV (40 cases) respectively according to the type of seizure.The changes of bone mineral density (BMD) and bone metabolism indexes including serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), osteocalcin (OC), parathyroid hormone (PTH), 25 hydroxyvitamin D [25-(OH)D] before treatment and at 3, 6 and 12 months after treatment were observed.Result:s (1) Bone metabolism indicators and BMD had no significant difference among groups before treatment (all P>0.05). (2) After 6 and 12 months of treatment in OXC group, Ca was lower than before treatment[2.38(0.08) mmol/L vs.2.47(0.17) mmol/L, 2.44(0.10) mmol/L vs.2.47(0.17) mmol/L], PTH was higher than before treatment[37.64(17.52) ng/L vs.34.23(20.53) ng/L, 40.74(16.15) ng/L vs.34.23(20.53) ng/L]; Ca in TPM group decreased after 6 and 12 months of treatment[2.40(0.11) mmol/L vs.2.42(0.10) mmol/L, 2.41(0.09) mmol/L vs.2.42(0.10) mmol/L], and the differences were statistically significant(all P<0.05). (3) After 6 and 12 months of treatment, Ca in the OXC group was lower than that in the LEV group[2.38(0.08) mmol/L vs.2.44(0.10) mmol/L, 2.44(0.10) mmol/L vs.2.44(0.12) mmol/L] and LTG group[2.38(0.08) mmol/L vs.2.44(0.13) mmol/L, 2.44(0.10) mmol/L vs.2.42(0.13) mmol/L], and PTH in the OXC group was higher than that in the LEV group[37.64(17.52) ng/L vs.36.52(20.71) ng/L, 40.74(16.15) ng/L vs.31.89(14.84) ng/L] and LTG group[37.64(17.52) ng/L vs.39.39(24.03) ng/L, 40.74(16.15) ng/L vs.33.01(12.20) ng/L], Ca in TPM group after 12 months of treatment was lower than that in the LEV group[2.41(0.09) mmol/L vs.2.44(0.12) mmol/L] and LTG group[2.41(0.09) mmol/L vs.2.42(0.13) mmol/L], and the differences were statistically significant(all P<0.05). Conclusions:In the new AEDs, LEV and OXC have no significant effect on bone metabolism.TPM may affect bone metabolism by reducing Ca in children with epilepsy, and OXC may cause the decrease of Ca and the increase of PTH, thereby leading to increased bone turnover in children with epilepsy.

Objective:To explore the nursing knowledge of extracorporeal membrane oxygenation (ECMO) in cardiac surgery nurses and analyze its influencing factors, in order to provide a reference for improving the nursing ability of clinical cardiac surgery nurses.Methods:Totally 104 nurses were selected from the Department of Cardiac Surgery, the First Affiliated Hospital of Zhengzhou University from January 2017 to January 2018, and investigated with the self-designed questionnaire of ECMO-related nursing knowledge and attitude. The status quo and influencing factors of ECMO nursing knowledge in cardiac surgery nurses were analyzed.Results:For the content of ECMO-related nursing knowledge, the percentages of nurses giving the 100% correct answers to "bleeding, anticoagulation problems and nursing measures", "nursing measures of the circulatory system", and "management of the catheter" were higher, being 92.31%, 88.46%, and 84.61% respectively, while the dimension to which the percentage of nurses giving 100% correct answers was the lowest was "prevention and control of related nosocomial infections", which was only 65.38%. The total proportion of nurses who gave 100% correct answers was 79.81%. There was no statistically significant difference in ECMO-related nursing knowledge scores between nurses at different ages ( P>0.05) . The difference in ECMO-related nursing knowledge and attitude scores between nurses with different working years, positions, and educational backgrounds was statistically significant ( F/t=96.834, 12.014, 44.726; P<0.05) . Multiple linear regression analysis showed that 1-3 years of working and educational backgrounds were the influencing factors to the difference in ECMO nursing knowledge scores between cardiac surgery nurses ( P<0.05) , and two variables could account for 65.7% of the variance of ECMO-related nursing knowledge scores in cardiac surgery nurses ( R2=0.657, P<0.01) . Conclusions:Cardiac surgery nurses have a good grasp of ECMO-related nursing knowledge, and 1-3 years of working and educational backgrounds were the influencing factors its scores. Cardiac surgery nurses still need to strengthen learning and training in terms of aseptic technical operation practices and related prevention measures for hospital infection.

Objective:To explore the characteristics of BCR-ABL1 kinase domain mutations in imatinib-resistant chronic myelogenous leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL) patients from Northeast China and their impact on prognosis. Methods:The clinical data of 252 CML patients and 49 Ph + ALL patients who were admitted to the First Hospital of Jilin University from January 2013 to October 2018 were retrospectively analyzed. The samples of bone marrow or peripheral blood were collected from patients when imatinib treatment was not effective. Nested polymerase chain reaction (PCR) was used to amplify the BCR-ABL1 kinase domain, and Sequencing Analysis v5.4 software was used to analyze the mutation of BCR-ABL1 kinase domain. Patients were followed up for 6-48 months, and the survival analysis was performed. Results:Among 252 CML patients, the mutations in ABL1 kinase domain were found in 57 patients (22.6%), including 25 patients in the chronic phase, 21 patients in the accelerated phase and 11 patients in the blast crisis; 50 patients had 20 types of single point mutation, and the most common mutation types were E255K (16.0%, 8/50), T315I (14.0%, 7/50), M244V (8.0%, 4/50) and G250E (8.0%, 4/50), which were all concentrated in the P-loop and C-helix domains; 7 patients had double mutations; patients with multiple mutations had the worst prognosis, with a median overall survival (OS) time of 3.2 months. Among 49 Ph + ALL patients, 17 cases (34.7%) were positive for mutations in the BCR-ABL1 kinase domain, 14 patients had 12 types of single point mutation, and 3 patients had multiple mutations; the median OS time of patients with multiple mutations, mutations located in the P-loop and C-helix domains and mutations located in the other domains was 2.0, 8.0 and 18.0 months, and the difference in OS among the three groups was statistically significant ( P < 0.01). Conclusions:Among the imatinib-resistant CML and Ph + ALL patients from Northeast China, point mutations in the P-loop and C-helix domains are most commonly found. Multiple mutations, mutations in the P-loop and C-helix domains are related to the poor prognosis of the patients.

Objective:To investigate the effects of levetiracetam on bone metabolism and thyroid hormone levels in children with epilepsy.Methods:A total of 20 children with epilepsy first diagnosed in our hospital from July 2016 to June 2017 were selected as the treatment group, the other 20 children who received physical examination in the same period were selected as the control group.The treatment group was given oral LEV monotherapy for 12 months.The changes of bone metabolism indexes[blood calcium, blood phosphorus, alkaline phosphatase activities, osteocalcin, parathyroid hormone, 25-(OH)D], bone mineral density(BMD)and serum thyroid hormone(triiodothyronine, tetraiodothyronine, free triiodothyronine, free thyroxine, thyroid stimulating hormone) in the control group and the treatment group were detected before, 6 and 12 months after medication.Results:(1)There were no statistically significant differences in bone metabolism indexes and BMD between the control group and the treatment group before medication( P>0.05). The differences showed no statistically significant in bone metabolism indexes and BMD among different time points of treatment group( P>0.05). (2)There were no significant differences in thyroid hormone levels between the control group and the treatment group before medication( P>0.05). There were no significant differences in thyroid hormone levels among different time points of treatment group ( P>0.05). Conclusion:Levetiracetam has no significant effects on bone metabolism and thyroid hormone level in epileptic children.

Objective:To explore the relationship between the expression of long chain non coding ribonucleic acid (LncRNA) small nucleolar RNA host gene 1 (LncRNA SNHG1) and microRNA (miR)-143-3p in nasopharyngeal squamous cell carcinoma (HSCC) tissue and clinical pathological features and prognosis.Methods:A prospective selection was made from 97 HSCC patients admitted to the Handan Central Hospital from March 2016 to March 2018. Surgical resection of HSCC tissue and normal mucosa tissue adjacent to cancer were taken, and real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of LncRNA SNHG1 and miR-143-3p. The patient′s survival status was followed up after leaving the hospital. We compared the differences in the expression of LncRNA SNlHG1 and miR-143-3p in HSCC tissues with different clinical pathological parameters, analyzed the correlation between LncRNA SNHG1 and miR-143-3p expression, and the relationship between LncRNA SNHG1 and miR-143-3p expression and the prognosis of HSCC patients.Results:The expression of LncRNA SNHG1 in HSCC tissue was higher than that in normal mucosa tissue adjacent to cancer ( P<0.05), and the expression of miR-143-3p was lower than that in normal mucosa tissue adjacent to cancer ( P<0.05). The expression of LncRNA SNHG1 in cancer tissues of HSCC patients with tumor node metastasis (TNM) stage Ⅲ, low to medium differentiation, and lymph node metastasis was higher than that of HSCC patients with TNM stage Ⅰ-Ⅱ, high differentiation, and no lymph node metastasis (all P<0.05), and the expression of miR-143-3p was lower than that of HSCC patients with TNM stage Ⅰ-Ⅱ, high differentiation, and no lymph node metastasis (all P<0.05). The expression of LncRNA SNHG1 in HSCC tissues is negatively correlated with the expression of miR-143-3p ( r=-0.522, P<0.05). The 5-year cumulative survival rate of HSCC patients with high expression of LncRNA SNHG1 was lower than that of HSCC patients with low expression of LncRNA SNHG1 ( P<0.05), and the 5-year cumulative survival rate of HSCC patients with low expression of miR-143-3p was lower than that of HSCC patients with high expression of miR-143-3p ( P<0.05). Multivariate Cox regression analysis showed that TNM stage Ⅲ and high expression of LncRNA SNHG1 were risk factors for poor prognosis in HSCC patients (all P<0.05), while high expression of miR-143-3p was a protective factor ( P<0.05). Conclusions:The expression of LncRNA SNHG1 is upregulated and miR-143-3p is downregulated in HSCC tissues, with a negative correlation between the two, which is related to the malignant pathological characteristics and poor prognosis of HSCC.

Objective:To report the clinical and genetic characteristics of a family of creatine transporter deficiency (CRTR-D) caused by SLC6A8 gene mutation.Methods:A patient, who came from Department of Neurology, Shanxi Children′s Hospital in September 2018, with epilepsy and unexplained general developmental retardation, was clinically examined. The medical history of his family was also collected. Genetic detection was performed to analyze their genetic causes.Results:The proband, a three years and three months old boy, was walking unsteadily, unable to speak and having frequent seizures, with increased urine creatine/creatinine ratio and decreased peak of cerebral creatine indicated by magnetic resonance spectrum. The proband′s uncle had the similar symptoms with him. The mother of the proband only showed some learning difficulties, while the father, sister and grandparents of the proband had no symptoms. The proband was found to have TTC deletion mutation of SLC6A8 gene (NM_005629), c. 1222_1224del (p.Phe408del), suggestting the diagnosis of X-linked CRTR-D. The proband′s mother and grandmother had heterozygous mutations. The proband′s uncle carried the same hemizygous mutation, which was not detected in the proband′s father, sister or grandfather.Conclusion:In this family of CRTR-D caused by SLC6A8 gene mutation, two female carriers with the same mutation presented different clinical features, suggesting phenotypic variation, which has a great significance in studying the correlation between genotype and phenotype.

Objective: To effectively reduce the concentration of poisons in cleanroom, protect the health of workers, realize the optimization and automatic control of the new return air device. And the influence of initial concentration, air volume, temperature and relative humidity of formaldehyde on the purification effect of the new return air device was explored. Methods: The purification effect of the new return air device installed with the activated carbon and the photocatalyst purification net or ordinary activated carbon purification network was tested in a 60 m³ simulated cleanroom. The concentration of formaldehyde was determined by solution absorption-phenol reagent spectrophotometry. Based on the single factor experiment to determine the combination of two purification nets. The effects of air volume, initial formaldehyde concentration, temperature and relative humidity on the purification effect of the new return air device were investigated by orthogonal test. Then, the performance parameters of the return air device to purify formaldehyde were determined. Results: The formaldehyde purification efficiency of the two types of purification nets in the new return air device was higher than that of the ordinary activated carbon purification network (P<0.05) . The combination of activated carbon and photocatalyst purification net has no effect on the formaldehyde purification efficiency of the return air device (P>0.05) . According to the direct analysis and variance analysis, air volume was the most sensitive factor (F value is 18.894, P<0.05) , followed by initial concentration (F value is 16.128, P<0.05) , while temperature and relative humidity have little effect (F value is 0.041 and 0.599, respectively, P>0.05) . LSD analysis showed that there was no significant difference in the purification efficiency of formaldehyde between 475 m³/h and 626 m³/h (P>0.05) . From the perspective of formaldehyde purification efficiency and energy saving, when the air volume is set to 475 m³/h, the new return air device has higher purification efficiency for high concentration of formaldehyde. Conclusion The new return air device consisting of activated carbon and photocatalyst purification net can play a good purification role in cleanroom with different temperatures and different humidity. Its formaldehyde purification efficiency is affected by air volume and initial concentration.