Objective To observe the clinical effect of artificial ventilation combined continuous positive airway pressure(CPAP) with removal of tracheobronchial foreign bodies for children and to explore the possibility and security of the method. Methods 60 children with tracheobronchial foreign body, underwent total intravenous anesthesia ,were randomly divided into A group and B group. Each group had 30 cases. A group was given artificial ventilation with CPAP. The bronchofibroscope was connected to anesthesia machine with side hole after induction for 3 minutes,and high fresh gas flow(10 ～ 15L/min) was given to maintain continuous positive airway pressure. B group were given high frequency jet ventilation(HFJV) ,60 ～ 100 bpm. The mask ventilation was given in stand of bronchofibroscope when SpO2 ＜ 90% and until SpO2 improved. MAP, HR, ECG, SpO2, PaO2, PaCO2 were monitored and recorded at time points: T0 (entered operation room), T1 (beginning of bronchofibroscopy), T2 (5 min after bronchofibroscopy), T3 (10 min after bronchofibroscopy), T4 (end of operation). The side effects, the rate of fail to bronchofibroscopy and the rate of intubations after operation in two groups were observed and recorded. Results The HR of post-anesthesia in two groups significantly decreased than those at T0 (P ＜ 0.01), but no difference showed in HR between two groups(P ＞ 0.05). SpO2 and PaO2 of post-anesthesia in two groups significantly increased than those at T0 (P ＜0. 01) ,PaO2 at T1 ,T2 ,T3 in A group were significantly higher than those in B group(P ＜0.05). PaCO2 gradually increased after bronchofibroscopy in two groups ,and the values in A group was significantly lower than in B group(P ＜0.05 or 0. 01). There were no significant differences in the rates of fail to bronchofibroscopy and of intubations after operation between two groups, but the total number of B group was higher. Conclusion Artificial ventilation with CPAP for children with removal of tracheobronchial foreign bodies was safe and practical, and has a better controllability, a minor effect to respiratory function, deserve popularizing.

Objective To investigate the clinical efficacy of ilaprazole and bismuth combined ten-day standard quadruple therapy and sequential therapy in the treatment of patients with Helicobacter pylori (H .pylori)infected chronic gastritis.Methods A total of 200 patients with H .pylori-positive chronic gastritis diagnosed by gastroendoscopy examination and rapid urease test (RUT)were randomly divided into standard quadruple therapy group and sequential therapy group,100 cases in each group.One group received ilaprazole,bismuth,amoxicillin-clavulanatepotassium and ofloxacin 10-day standard quadruple therapy, and the other group received ilaprazole, amoxicillin-clavulanatepotassium, ofloxacin and furazolidone 10-day sequential therapy.In four to six weeks after the therapy,the condition of H .pylori eradication was detected by a 14 C-urea breath test.The improvement of clinical symptoms and adverse effects were also observed. Normal distributed and variance homogenized measurement data were compared by t test,while unordered categorical data were analyzed by chi-square test and the exact probability method,and categorical data were compared by two independent sample rank sum test.Results The per-protocol analysis values of H .pylori eradication rates of the standard quadruple therapy group and the sequential therapy group were 88.54%(85/96)and 87.23%(82/94),respectively,while the intention-to-treat analysis values were 85 .00%(85/100)and 82.00%(82/100 ),respectively.The effective rates of symptomatic relief of upper abdominal pain,acid regurgitation,heart burning in the standard quadruple therapy group and the sequential therapy group were 95 .83%(92/96)and 95 .74%(90/94),respectively. The incidence of adverse effects which weve very mild was 6.25 % (6/96 ) and 7.44% (7/94 ), respectively.There was no statistically significant difference in the above three factors between the two groups (all P >0.05).Conclusions Ilaprazole and bismuth combined 10-day standard quadruple therapy and sequential therapy in the treatment of patients with H .pylori positive chronic gastritis both achieves high rates of H .pylori eradication and symptom relief with mild adverse effects.

Objective:To analyze the clinical characteristics and prognosis of patients with primary aldosteronism (PA) associated with subclinical Cushing syndrome (SCS).Methods:This retrospective cohort study was conducted at the First Affiliated Hospital of Chongqing Medical University in China. Patients with PA were included between January 2014 and December 2022. According to the results of 1-mg overnight dexamethasone suppression test, the patients were divided into the PA group and PA associated with SCS (PA/SCS) group. The demographic information, hormone levels, and follow-up results were analyzed. Independent sample t-test, chi-square test and Mann-Whitney U test were used for data comparison. Results:A total of 489 PA patients were enrolled in this study, of which 109 had PA/SCS (22.3%). Patients with SCS were on average older (54.4±10.7 vs . 47.4±11.0, P<0.001); had a larger proportion of women (69.7%, 76/109 vs . 57.4%, 218/380; P=0.020); and a longer duration of hypertension [96 (36, 180) vs . 60 (12, 120) months, P=0.001] than patients without SCS. There were 215 and 51 patients in the PA group and PA/SCS group, who completed adrenalectomy and follow-up, respectively. The remission rate of autonomous cortisol secretion in the PA/SCS group was 85.3% (29/34). There was no significant difference in the remission rate of autonomous aldosterone secretion among patients between the PA/SCS and PA group (94.1%, 48/51 vs. 94.4%, 203/215; P=1.000), while the clinical remission rate in the PA/SCS group was lower than that in the PA group (39.2%, 20/51 vs. 61.9%, 133/215; P=0.003). Conclusions:SCS is common in PA patients (22.3%), and the clinical remission rate is low. Screening using the 1-mg overnight dexamethasone suppression test is recommended for all patients with PA.

OBJECTIVE： To provide reference for the clinical use and dosage form development of Strychnos nuxvomica. METHODS： The prescriptions containing S. nuxvomica were collected and sorted from the Dictionary of Traditional Chinese Medicine Prescription， and then formula name， prescription source， name of treatment disease， composition， usage and dosage， medication route were input into Access 2010 and database was established. According to the usage， these prescriptions were divided into internal use and external use， and the frequencies of diseases treated by internal/external use prescriptions were counted respectively. Apriori algorithm of SPSS Modeler 18.0 software was used to analyze the drug combination rule of compound prescription containing S. nuxvomica. RESULTS： A total of 78 prescriptions were included， of which 42 were oral prescriptions， 33 were external prescriptions and 3 were both oral and external prescriptions. Internal prescriptions were used to treat diseases such as atrophy-flaccidity disease， arthralgia， hemorrhoids， anal fistula， bones and muscles pain. The external prescriptions were mainly used to treat skin diseases， tumors， lump. Internal and external prescriptions could treat sore， injuries and fractures. In internal prescriptions， S. nuxvomica was often compatible with Boswellia carterii， myrrha， Daemonorops draco， Manis pentadactyla， pyritum， Angelica sinensis， Ephedra sinica， Aconitum kusnezoffii. In external prescriptions， S. nuxvomica was often compatible with Radix Paeoniae， Rehmannia glutinosa， Phellodendron chinense， Coptis chinensis， Scutellaria baicalensis， Angelica sinensis， Angelica dahurica， Buthus martensii. Most of S. nuxvomica were used after processing， and mainly took sesame oil as an auxiliary material （77.97％）. CONCLUSIONS： Diseases treated with the prescriptions containing S. nuxvomica can be classified into three types of diseases， i.e. polymyalgia rheumatica and paralysis， bruise and bone fracture， carbuncle and stubbornness tinea. In external prescriptions， S. nuxvomica is often compatible with drug for clearing heat and drying dampness， cooling blood and activating blood， and relieving pain. In internal prescriptions， S. nuxvomica is often compatible with the agents for blood-activating and stasis-resolving medicinal. In addition， the processing of S. nuxvomica with sesame oil is an important measure to ensure its safety.