Objective To discuss the curative effects and clinical safety of high -dose glucocorticoids (GCS)combined with short -range hormone therapy for myasthenia gravis(MG).Methods The clinical data of 68 patients with MG were retrospectively analyzed.They were divided into the control group and the observation group (34 cases in each group)according to different treatment methods.The control group was treated by high -dose GCS combined with long -term hormone therapy,while the observation group received large doses of GCS short -range hormone treatment combined with other immunosuppressive therapy.Before and after treatment,curative effects and adverse reactions of the two groups were recorded and compared.Results The onset time of the control group and the observation group was respectively (7.8 ±3.5)days,(8.2 ±4.2)days;Before treatment,and after 4 weeks,8 weeks, 12 weeks treatment,the clinical absolute scores of the control group were (24.7 ±10.5)points,(15.4 ±6.3)points, (6.8 ±5.4)points,(7.1 ±4.5 )points,which of the observation group were (25.2 ±11.1 )points,(16.9 ± 7.1)points,(7.4 ±4.8)points,(8.3 ±5.5)points.The onset time and clinical absolute scores of the two groups had no statistical differences(t =0.978,0.925,0.897,1.213,all P >0.05);After 4 weeks of treatment and 12 weeks of treatment,the total effective rates in the control group were 85.3%,94.1% respectively,which of the observation group were 76.5%,91.2% respectively,the two groups had no statistically significant differences (χ2 =0.856, 0.216,all P >0.05);The incidence rate of adverse reactions in the control group (38.2%)was significantly higher than 14.7% in the observation group(χ2 =4.836,P <0.05).Conclusion Large dose of GCS combined with short-range hormone has adequate curative effects compared with large dose of GCS long -range hormone for the treat-ment of myasthenia gravis,but it had the lower incidence of adverse reactions,which is worthy of clinical promotion.

Objective To study the clinical efficacy and safety of Yanhuning injection in the treatment of bronchial pneumonia in children.Methods 102 cases of bronchial pneumonia were randomly divided into the observation group and the control group,51 cases in each group.The control group was given conventional treatment, the observation group was given Yanhuning injection on the basis of the treatment of control group.The clinical efficacy after treatment,clinical symptoms and signs disappeared time and adverse drug reaction were compared between the two groups.Results In the observation group after treatment,the cured,improvement,invalid cases were 27 cases, 23 cases,1 case,the total effective rate was 98.04%,which in the control group were 18 cases,25 cases,8 cases,the total effective rate was 84.31%.The total effective rate of the observation group was significantly higher than that of the control group (χ2 =5.97,P <0.05).The cough asthma,shadows in the lungs,pulmonary rales and heating time in the observation group were (5.19 ±2.31)days,(6.00 ±1.86)days,(5.16 ±1.51)days,(2.07 ±0.85)days, which were significantly shorter than those of the control group,the differences were statistically significant (t =4.23, 5.01,3.95,384,all P <0.05).The incidence rate of adverse drug reactions in the observation group was 25.49%, and the difference was not statistically significant compared with the control group (P >0.05).Conclusion Yan-huning injection for the treatment of children with bronchial pneumonia can significantly improve the clinical curative effect,shorten the disappearance time of the clinical symptoms and signs,the curative effect is reliable,high security.

Objective To investigate the clinical effect of montelukast sodium in the treatment of cough vari-ant asthma in children,to provide reference for clinical treatment.Methods 128 cases of children with cough variant asthma were randomly divided into observation group and control group of 64 cases.The control group with routine measures for the treatment of asthma in children for treatment,the observation group in the control group based on the treatment regimen,plus montelukast sodium chawing treatment.The changes of the two groups were compared after 12 weeks of treatment,the clinical efficacy and lung function indexes before and after treatment.Through 6 months of follow -up,the recurrence of the disease between the two groups after treatment.Results The effective rate in the observation group was 43.75%,the total effective rate was 93.75%,which were significantly higher than those of the control group (χ2 =4.53,P <0.05);the two groups after treatment of FEV1 ,FVC,FEV1 /FVC,PEF and PEF during the day at night were significantly higher than those before treatment (t =4.11,3.23,3.82,5.12,3.12,5.54,4.31, 4.98,6.22,4.45,all P <0.05);After treatment,the FEV1 [(3.08 ±0.43)L],FVC[(3.89 ±0.52)L],FEV1 /FVC [(75.95 ±6.51)%],PEF day[(3.24 ±0.91 )L/s],PEF for the night[(3.51 ±1.01 )L/s]of the observation group were significantly higher than those of the control group (t =3.67,3.10,3.43,2.92,3.01,all P <0.05);The recurrence rate of the observation group was 3.13%,which was significantly lower than that of the control group (χ2 =4.82,P <0.05).Conclusion The clinical efficacy of montelukast can significantly improve cough variant asthma in children,improve children's lung function,reduce the recurrence rate of cough variant asthma.

Objective: To investigate the curative effect of low-frequency therapeutic instrument of hepatopathy combined with Reduning injection in clinical treatment for patients with scarlet fever and hepatitis injury. Methods: 94 patients with scarlet fever and hepatitis injury were divided into observation group (47 cases) and control group (47cases). Patients of control group received the therapy of Reduning injection combined with tablet of adefovir dipivoxil, while the patients of observation group received the therapy of therapeutic instrument of hepatopathy combined with the therapy of control group. The changes of curative effect, indicator of hepatic fibrosis and response rate between two groups were observed. Results: The total effective rate of the observation group (95.7%) was significantly higher than that of control group (70.2%) (x2=7.283, P<0.05). In observation group, the hepatic fibrosis hyaluronic acid, III type procollagen, IV type collagen and laminin of post-treatment were significant improvement than that of pre-treatment (t=3.42, t=2.83, t=2.74, t=2.52, P<0.05). While in control groups, only the laminin of post-treatment was significant improvement than that of pre-treatment (t=2.15, P<0.05). After treatment, CR, VR, BR and HBeAg of observation group were significant higher than that of control group (x2=5.235, x2=5.623, x2=4.993, x2=6.823, P<0.05). Conclusion: The combination of low-frequency treatment of hepatopathy and Reduning injuection for the treatment of patients with scarlet fever and hepatic injury has significant effect, and it can effectively enhance the conversion rate of HBeAg, and improve liver function of patients. Therefore, it is worthy to be further promoteed in the clinical application.

ObjectiveTo evaluate the efficacy of preemptive analgesia with parecoxib for acute postoperative pain after pulmenary lobectomy.MethodsSixty ASA Ⅱ or Ⅲ patients of both sexes aged 20-64 yr weighing 50-80 kg undergoing elective pulmonary lobectomy were randomly divided into 3 groups ( n =20 each): control group (group C); group A (parecoxib 40 mg was injected iv at 20 min before surgery) and group B (parecoxib 40 mg was injected iv when skin was sutured).Patient controlled intravenous analgesia (PCIA) with sufentanil and ramosetron (continuous background dose 2 ml/h,bolus dose 0.5 ml,lockout time 15 min) was used after surgery.When VAS score ＞ 3,iv bolus of tramadol 1-2 mg/kg was injected as rescue medicine.Agitation condition was observed after operation.The number of successfully delivered doses and the number of attempt were recorded.The consumption sufentanil and the number of rescue medicine were recorded during 24 h after surgery.ResultsThe incidence of postoperation agitation,number of successfully delivered doses and number of attempt,consumption sufentanil and number of rescue medicine were significantly lower in groups A and B than in group C.The consumption sufentanil and number of rescue medicine were significantly lower in group A than in group B ( P ＜0.05).ConclusionParecoxib can use for preemptive analgesia in patients after thoracic surgery,reduce the complication during anesthesia recovery and the opioid analgesics consupmtion.

Transcatheter arterial chemoembolization (TACE) is the first choice of patients with hepatocellular carcinoma (HCC) missed opportunity of exairesis.Angiogenesis is one of the key factors that affect prospective efficacy.Counter-measures against angiogenesis mainly contain complete embolization of tumor blood supply and integration with angiogenesis inhibitors.The angiogenesis after TACE and the corresponding countermeasures were reviewed in this article.

Objective To explore the effect of personalized intervention on drug compliance in patients with multidrug-resistant pulmonary tuberculosis. Methods A total of 80 patients with multidrug-resistant pulmonary tuberculosis were selected from March 22, 2016 to March 22, 2017, and randomized groups were randomly divided into the observation group and the control group,40 cases in each groups . The observation group and the control group Intervention and routine care. Results Observation group of patients satisfaction score (97.92±1.24), compliance score (95.42±3.14), the incidence of adverse events (5.00%), reasonable nutrition rate (100.00%), prescribed medication rate (100.00%), don't do STH without authorization (100.00%), rate of quitting cigarettes, alcohol and drug withdrawal rate (95.00%), and regularly review rate (95.00%), the psychological function (97.53±1.22) and body function (96.18 ± 1.42) points (95.31±2.41), material life, social function (94.82± 3.42mm) were better than control group (P<0.05).Conclusion Individualized intervention in multidrug-resistant tuberculosis patients can improve drug compliance.

Objective To understand the content of discharge guidance for lung cancer patients ,and to provide evidence for improving the quality of lung cancer .Methods Using convenient sampling method ,a sample of 212 patients with lung cancer in the Department of Thoracic Oncology ,a third‐class hospital in Sichuan province was surveyed by general data questionnaire and dis‐charge guidance quality questionnaire .Results The total discharge guidance quality was (195 .93 ± 39 .98) points and was at a high level .The score of discharge guidance requirement(48 .69 ± 11 .51) was higher than that of discharge instruction (47 .35 ± 11 .34) , the difference was statistically significant(P<0 .05) .There was significant difference in the scores of different age ,educational lev‐el ,living style and the patients with central venous catheter (PICC/CVC) ,the difference was statistically significant (P<0 .05) . Conclusion Patients with lung cancer were discharged from the hospital with a higher level of guidance ,and the content of dis‐charge guidance from patients with lung cancer was far from meeting the requirements .It should be based on the age ,education and living style of patients with lung cancer ,especially for strengthening the guidance of discharged patients with PICC/CVC ,improving the quality of discharge guidance and promoting the rehabilitation of lung cancer patients .

Hypoxia-induced factors(HIFs)are the main regula-tors for the response of hypoxic environment.They are involved in hypoxia-related lung tissue cell damage and abnormal cell pro-liferation,among which,HIF-1αand HIF-2αplay the most im-prominant roles.This paper reviews the current researches of HIF-1αand HIF-2α,focusing on their structural and functional similarities and diversities,as well as their roles in the patho-genesis of hypoxic pulmonary hypertension.

An 18-year-old woman was admitted to the hospital for swelling of the right lower limb and vulva with milky-white vesicles for 3 years.Skin examination revealed swollen and enlarged right lower limb and labium,numerous clustered or scattered pinhead-to millet-sized whitish thick-walled vesicles over the right labium majus,bilateral labium minus,vaginal orifice,and right thigh,with milky-white chylous fluid draining from the vagina.Magnetic resonance imaging revealed obvious lymphangiectasia in the lower abdominal cavity and right side of the pelvis,dilation and distortion of lymphatic vessels in the skin and subcutaneous tissue of the right inner thigh,the vaginal wall and at the medial side of the right labium majus,but no abnormality in the uterus.Histopathological examination of the milky-white vesicles showed cystic dilation of lymphatic vessels in the superficial dermis,and fibrous hyperplasia of the middle and lower dermis.A diagnosis of primary chylous reflux syndrome Ⅰ was made.