Status epilepticus(SE)is one of the most common medical emergencies in children.There has been some recent understanding of this fife-threatening condition with reference to the definition,forms of ignorable seizure,drug treatment and role of EEG monitoring.This review discusses the current information regarding the definition,diagnosis,treatment of status epilepticus and the latest advance on management of refractory SE in children.

Objective To adopt the network meta analysis method to compare the incidence difference of cutaneous squamous-cell carcinoma(SCC)and rash in 5 kinds of targeted drugs regimen for treating malignant melanoma.Methods PubMed and Cochrane Library databases were retrieved by computer.The retrieval range was from their establishment to November 2015.The network meta analysis pooled the evidences of direct and indirect comparison for evaluating the pooled odds ratio(OR)and cumulative probability of cutaneous complications occurrence difference in 5 kinds of targeted drugs regimen for treating malignant melanoma.Results Six randomized controlled trials(RCTs)conforming to the inclusion criteria were included.The meta analysis results revealed that compared with Dabrafenib+Trametinib,the cutaneous SCC occurrence rate of Vemurafenib was higher(OR=9.20,95％CI=1.26-52.53),while the rash occurrence rate of Vemurafenib+Cobimetinib was higher(OR=6.81,95％CI=1.01-41.87).The surface under the cumulative ranking curves(SUCRA)value showed that adopting Trametinib had the lowest occurrence rate for SCC,and adopting Dabrafenib+Trametinib had the lowest occurrence rate of rash.Conclusion Dabrafenib+Trametinibis generate the lowest complication incidence rate of malignant melanoma.

OBJECTIVE:A method was established for determining the content of estriol in estriol suppositories.METHO_ DS:Using three wavelength spectrophotometry.RESULTS:The detecting wavelengths were296nm,281nm and276nm;the average recovery rate of estriol was99.2%(RSD=0.5,n=6).CONCLUSION:The method is accurate,quick and suitable for detecting estriol in intermediate material of estriol suppositories.

Objective To evaluate the effects of problem-based learning (PBL) teaching mode and lecture-based learning (LBL) teaching mode applied in clinical teaching of dermatology in China.Methods All studies on PBL teaching mode and LBL teaching mode applied in clinical teaching of dermatology in China published from 1990 to 2015 were identified by searching in CNKI,VIP database,Wanfang data and so on.Meta-analysis was performed by RevMan 5.3 software.Results Six random controlled trials on 710 clinical students qualified for the meta-analysis according to our criteria.The students in PBL group got significant higher scores than those of the students in LBL group in theoretical scores [WMD=3.75,95％CI=2.58-4.92,P＜0.05],clinical skills tests [WMD=5.27,95％CI=4.60-5.94,P＜0.05] and total scores [WMD=7.93,95％CI=6.49-9.37,P＜0.05].Conclusion PBL teaching mode is an effective mode on teaching of dermatology in China,particularly for theoretical scores and clinical skills,compared with LBL mode.

OBJECTIVE:To analyze the ADRs caused by Chinese prepared medicines.METHODS:638ADRs were col?lected from medical journals of2001～2002in consideration of sex,age,administration route,the time of the occurrence and clinical manifestations.RESULTS:There were638ADR cases involving76kinds of Chinese prepared medicines reported in256articles.Of them,shuanghuanglian injection was the most common preparation(87cases).The commonest clinical manifesta?tions were allergic reactions(157cases),followed with the liver and kidney injury.The ages of patients were mostly above60years,the time of the occurrence was mostly within30minutes after administration and about92%of the patients recovered within24hours.CONCLUSION:The occurrence of ADRs of Chinese prepared medicines is related to the route of administra?tion,dosage form of drug,quality of drug,patient’s age and constitution.

Objective To investigate the value of plasma chromogranin A (CgA) in the diagnosis of neuroendocrine tumors (NETs), and to evaluate the diagnostic efficacy of plasma CgA in different gastrointestinal pancreatic neuroendocrine tumors (GEP NETs). To investigate the role of monitoring plasma CgA in the progress of GEP NETs. Methods ELISA kits were used to measure the CgA plasma level in 56cases of GEP NETs, 52 cases of pheochromocytoma, and 7 cases of small cell lung cancer (SCLC) and 52cases of normal controls respectively. The sensitivity and specificity of plasma CgA in diagnosis of gastrointestinal pancreatic endocrine tumor; pheochromocytomas and SCLC were calculated. The group of GEP NETs included 13 cases of gastrointestinal carcinoid tumors, 13 cases of gastrinomas, 12 cases of islet cell tumors and 18 cases of other type tumors of GEP NETs. The differences of plasma CgA levels and various sensitivities were compared in different types tumors of GEP NETs. Meanwhile the value of plasma CgA in the diagnosis of metastatic and nonmetastatic tumors in GEP NETs was determined. Results The median CgA levels and quartile of the groups of GEP NETs, pheochromocytomas and SCLCs were 84. 5U/L and 38. 3-175.5 U/L, 154.0 U/L and 53. 3-243.8 U/L, and 55.0 U/L and 19.0-79.0 U/Lrespectively, which were significantly higher than that of ( 18. 5 U/L and 12. 3-25. 8 U/L) normal controls (P＜0. 001 ). The sensitivities of CgA in diagnosis of GEP NETs, pheochromocytomas and SCLCs were 82. 1%, 88.5% and 57. 1% respectively, and the specificities were all 96.2%. In the group of GEP NETs, the CgA level of gastrinoma was significant higher than the groups of carcinoid, islet cell tumor, and other type tumors of GEP NETs. The sensitivities of CgA in diagnosis of gastrinoma, carcinoid tumors, and islet cell tumors were 92. 3%, 84. 6% and 50. 0% respectively. In the group of GEP NETs, it showed significant differences in CgA levels in patients with metastatic and non-metastatic tumors. Conclusion The plasma CgA levels were elevated significantly in the GEP NETs, and showed a high sensitivity and specificity particularly in the diagnosis of gastrinoma. CgA also can be used as a marker in monitoring tumor development and evaluating prognosis during the clinical application.

The peptides,proteins and other biological molecules in transudative pleural effusion correlate directly or indirectly with specific physiological and pathological state,reflecting the information regarding the lungs or other parts of the body.In the present study,the peptide fraction in transudative pleural effusion was isolated by uhrafiltration.After desalted and enriched by C18 tips,the peptide mixture was analyzed by nano LC-MS/MS.The results showed that 314 peptides,which were originated from 52 proteins,in pleural transudate were identified.More than half of the peptides were derived from fibrinogen.Many peptides were characterized as displaying ladder sequences.In addition,a large number of proline oxidation modifications were detected in the peptides derived from collagen and fibrinogen.Gene ontology enrichment analysis showed that the most of the proteins extracellular properties of pleural transudate polypeptide components were protein with exocytosis.The study provided a rapid and efficient separation and analysis methods for lung disease markers related peptide compounds in pleural fluid leakage.Also this research provided a rapid and effective method for screening peptide biomarkers related to lung diseases from transudative pleural effusion.

Objective:To evaluate the clinical efficacy of Huzhang Polou Decoction combined with acupoint application in the treatment of children with mycoplasma pneumoniae pneumonia (MPP) complicated with atelectasis.Methods:A total of 105 MPP children with atelectasis and phlegm-heat obstructing lung syndrome in our hospital from August 2019 to March 2022, who met the inclusion criteria, were divided into control group (53 cases) and observation group (52 cases), by random number table method. The control group was given azithromycin sequential therapy on the basis of conventional western medicine treatment, and the observation group was given Huzhang Polou Decoction and acupoint application on the basis of the control group. Both groups were treated for 19 days. TCM syndromes were scored before and after treatment. The FEV1 and peak expiratory flow rate (PEF) were measured by pulmonary function measurement instrument. The CRP was measured by immunoturbidimetry and procalcitonin (PCT) was measured by ELISA. The recovery time of fever, disappearance time of cough and sputum, disappearance time of lung rales, lung recruitment time, and adverse reactions during treatment were recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 96.15% (50/52) in the observation group and 84.91% (45/53) in the control group, and the difference between the two groups was statistically significant ( χ2=3.85, P=0.050). After treatment, the TCM syndrome score of the observation group was significantly lower than that of the control group ( t=22.78, P<0.01). FEV1 [(1.87±0.29) L vs. (1.54±0.28) L, t=5.93] and PEF [(79.82±6.29) L/min vs. (74.32±6.30) L/min, t=4.48] were significantly higher than those in the control group ( P<0.01). The levels of serum CRP [(9.18±2.98) mg/L vs. (12.34±3.00) mg/L, t=5.42] and PCT [(0.60±0.15) ng/L vs. (0.96±0.21) ng/L, t=9.93] were significantly lower than those in the control group ( P<0.01). The recovery time of fever, disappearance time of cough and sputum, disappearance time of lung rale and lung recruitment time in the observation group were significantly earlier than those in the control group ( t=7.27, 6.84, 3.76, 5.87, all Ps<0.01). During treatment, the incidence of adverse reactions was 3.77% (2/53) in the control group and 1.92% (1/52) in the observation group, and there was no significant difference between the two groups ( χ2=0.32, P=0.569). Conclusion:The Huzhang Polou Decoction combined with acupoint application can improve the pulmonary function of children with MPP complicated with atelectasis, reduce the level of serum inflammatory cytokines, improve the clinical efficacy safely.

Objective To verify and monitor the performance of accuracy, precision and comparability of 26 clinical biochemical analytes (29 methods) in the six centers involved in multi-centers reference intervals research, and to ensure the reliability of theirmeasurement results.Methods During the period of the systems evaluating, two levels of commercial quality control materials and fresh frozen human serum reference materials were applied to verify the performance of inter-laboratory precision and accuracy of analysis systems. During the period of samples testing, the commercial quality control materials were measured whenever samples were analysed, the fresh frozen serum reference materials were measured once a month.The coefficient of variations (CVs), bias and total errors were calculated to assess the precision, accuracy and comparability.Results Verification of precision and accuracy: ( 1 ) the ranges of CVs of 29 methods in the six laboratory laboratories were 0.4%-6.0%, the CVs of all 29 methods met the criterion . (2) The overall average bias of the analysis systems of 21 analytes (24 methods) ranged from -5.15%( ALT) to 4.46% ( Ur ) .Among 24 methods the overall average bias of TP, Glu-GOD, Ur, Cl, Ca exceeded the acceptable range.The quality assessment during the period of samples testing:(1) The overall average bias ranged from -1.95%(Ca) to 2.92%(Ur), median 1.26%, they all met the requirements of relevant standards.( 2 ) When commercial control materials were tested, the requirements of CVs were fulfilled for most methods in the six laboratories,and the CVs of TP, Alb, Cl, Ca exceeded the acceptable range.The overall average TE of all methods met the quality specification for the C-N controls material.For the C-P control material, only the overall average TE of TP (5.05%) exceeded thearceptable range while the other methods met the requirement in criterion.Conclusions The performance of precision and accuracy of the analysis systems used in the six laboratories passed the verification.During the period of sample testing, the performance of precision and accuracy of the most methods in the 6 laboratories met the requirements of quality specifications, and the overall performance was good.Because of the limitation of current technology the performance of some methods didn't fulfill the requirement of specifications, and need to be improved.

Objective:To study the change in serum fibroblast growth factor 21(FGF21)level and its correlation with liver functions in elderly patients with hepatitis B virus(HBV)-related cirrhosis.Methods:A total of 150 elderly patients with HBV infection admitted to Beijing Ditan Hospital and China-Japan Friendship Hospital from January 2019 to December 2020 were selected and divided into chronic hepatitis B(CHB)group(n=70)and HBV-related cirrhosis group(n=80). Healthy subjects were selected as the control group(n=50). Serum FGF21 was determined by ELISA method.Clinical data, clinical laboratory indicators and FGF21 as a core parameter of this study were collected and compared among control group, CHB group, HBV-related cirrhosis group.The correlations of FGF21 level with several liver function indexes were analyzed by Pearson correlation analysis.Results:The levels of total bilirubin(TBil)and total biliary acid(TBA)were significantly higher in HBV-related cirrhosis group than in CHB group.The levels of aspartate transaminase(AST), alanine transaminase(ALT), glutamyl transpeptadase(GGT), serum albumin, cholinesterase, FGF21 and HBV-DNA were significantly lower in HBV-related cirrhosis group than in CHB group(all P<0.05). The levels of serum FGF21 were(108.6 ± 7.3)ng/L, (92.5 ± 7.6)ng/L and(75.8 ± 6.3)ng/L in Child-Pugh A, B and C patients, respectively.The level of FGF21 was statistically significantly decreased with the increase of Child-Pugh grading( F=18.290, P=0.000). Serum FGF21 level was positively correlated with AST, ALT, TBil, cholin-esterase and albumin levels( r=0.652, 0.579, 0.609, 0.558, 0.613, all P<0.05). Conclusions:The level of serum FGF21 is significantly decreased in elderly patients with HBV-related cirrhosis, and is positively correlated with liver function indexes.