H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Objective:To investigate the expressions of apoptosis-related factors survivin, p53 and human epidermal growth factor receptor 2 (HER2) in breast cancer tissues and their prognostic value.Methods:A total of 131 patients undergoing radical mastectomy for breast cancer who were admitted to Tangshan Maternal and Child Health Care Hospital from February 2015 to January 2019 were selected as the research subjects. During the operation, the cancer tissues and adjacent tissues (normal tissues >3 cm from the tumor margin) were collected from the patients. Expressions of survivin, p53 and HER2 in cancer tissues and adjacent tissues of patients were detected by using immunohistochemistry. The prognoses of patients were recorded after the follow-up for 3 years; the recurrence, metastasis and death treated as the poor prognosis, the rest prognoses of patients were treated as the good prognosis group. The difference of clinicopathological characteristics between the poor prognosis group and the good prognosis group was compared. Multivariate logistic regression was used to analyze risk factors for prognosis of breast cancer patients. The result of prognosis of breast cancer was taken as the golden standard. The receiver operating characteristic (ROC) curve was used to analyze the value of survivin pasitive, p53 pasitive, HER2 pasitive alone, the combination of both and the combination of the there in the judgement of poor prognosis of breast cancer.Results:The positive expression rates of survivin [49.6% (65/131) vs. 7.6% (10/131)], p53 [60.3% (79/131) vs. 13.0% (17/131)] and HER2 [79.4% (104/131) vs. 16.8% (22/131)] in cancer tissues were higher than those in adjacent tissues (all P<0.001). A total of 131 breast cancer patients were followed up for 3 years without any loss of follow-up, and the follow-up rate was 100%. Within the follow-up for 3 years, there were 15 (11.5%) cases of recurrence, 8 (6.1%) cases of metastasis, and 10 (7.6%) cases of death, the incidence of poor prognosis was 25.2% (33/131); and the remaining 98 cases had good prognosis. The proportions of patients with TNM stage Ⅲ, lymph node metastasis, poorly differentiated histology, tumor diameter ≥3 cm, survivin, p53, and HER2 positive expressions in the poor prognosis group were higher than those in the good prognosis group (all P<0.05). Multivariate logistic regression analysis showed that TNM stage Ⅲ [ OR = 5.323 (95% CI 2.190-12.936)], lymph node metastasis [ OR = 4.773 (95% CI 1.964-11.600)], tumor diameter ≥3 cm [ OR = 3.582(95% CI 1.474-8.706)], positive survivin [ OR = 2.740 (95% CI 1.127-6.659)], positive p53 [ OR = 3.271 (95% CI 1.346-7.949)], and positive HER2 [ OR = 3.873 (95% CI 1.594-9.412)] were independent risk factors for prognosis of breast cancer (all P<0.001). The ROC curve results showed that the area under the curve (AUC) values of survivin positive, p53 positive,HER2 positive, and the combination of any two were more than 0.80 (all P<0.001); the AUC of the combination of the three was 0.944 (95% CI 0.890-0.977) ( P<0.001). Conclusions:The expressions of survivin, p53, and HER2 are highly expressed in breast cancer tissues. The expressions of the three can be used to judge the prognosis of breast cancer patients, and the combination of the three has a higher judgement value.

Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.

Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.

Objective To establish and improve the quality standard of ginkgo semen decoction pieces. Methods The morphological character for 29 batches of ginkgo gemen and 12 batches of stir-fried ginkgo gemen were observed, and the moisture contents were assayed using the method in Chinese Pharmacopoeia 2015 edition, the first supplement. Results The character of ginkgo gemen and stir-fried ginkgo gemen were consistent in different batches. The moisture content of ginkgo gemen was 8.8% to 12.2%, with an average of 10.5%. The moisture content of stir-fried ginkgo gemen was from 5.4% to 12.3%, with an average of 8.9%. Considering that ginkgo semen decoction pieces are stored for a long time, they are prone to the attack of mildew and insects, and the moisture limit is set to be no more than 10.0% in ginkgo gemen and stir-fried ginkgo. Conclusion Compared with the Chinese Pharmacopoeia 2015 edition, the first supplement, the character identification for ginkgo semen decoction pieces was added and the quality standards were improved. The moisture content of ginkgo semen decoction pieces needs to be strictly controlled under 10.0% to prevent mildew and insects.

Objective:To investigate the clinical efficacy of interlocking intramedullary nailing in the treatment of patients with traumatic long tubular fractures of the lower limbs.Methods:From April 2018 to October 2019, 114 patients with traumatic long tubular bone fractures of the lower extremity who were treated in the Department of Orthopaedics of the People's Hospital of Dongyang were selected.They were divided into two groups according to the random number table method, with 57 patients in each group.The control group received plate internal fixation, the observation group used interlocking intramedullary nailing.The treatment effect, operation time and complications of the two groups were compared.Results:The total effective rate in the observation group (98.25%) was higher than that in the control group (66.67%), the operation time [(69.87±3.46)min] and the incidence of complications (5.26%) were lower than those in the control group [(90.14±7.47)min, 19.30%], and the differences were statistically significant (χ 2=19.646, 5.211, t=18.589, all P<0.05). Conclusion:Compared with traditional steel plate internal fixation, interlocking intramedullary nail internal fixation is more effective in the treatment of patients with traumatic long tubular bone fractures of the lower extremities, the operation time is shorter, and the probability of postoperative complications is lower and has certain clinical value.

Objective:To evaluate the efficacy and safety of oxycodone combined with dexmedetomidine in the postoperative analgesia in the patients underwent laparoscopic radical surgery of colon cancer.Methods:Sixty colon cancer patients underwent laparoscopic radical surgery and recevied patient-controlled intravenous analgesia after operation were randomly divided into control group and experiment group (n=30)using The "Envelope Method". The patients in control group were given 0.5 mg·kg-1 oxycodone,and the patients in experiment group were given 0.5 mg·kg-1 oxycodone and 2 μg·kg-1 dexmedetomidine.The parameters of analgesic pump in two groups were set as follows:the continuous perfusion rate was 1 mL·h-1 ,the single bolus was 1.5 mL,the lock-out time was 10 min,and the total volume was 100 mL.The VAS scores of pain at rest and activity pain of the patients in two groups were evaluated at exiting the post anesthesia care unit (T1 ),and at 6 h (T2 ),12 h (T3 ),24 h (T4 )and 48 h (T5 )after operation.The dose of analgesic drugs used,times of emergent rescue analgesia and anus exhaust time after operation of the patients in two groups were recorded;the postoperative adverse responses,vital signs and Ramsay scores of the patients in two groups were observed.Results:The VAS scores of activity pain at T2 -T5 and pain at rest at T2 -T4 of the patients in experiment group (P T2-T5 =0.000;P T2 =0.018,P T3 =0.001,P T4 =0.010)were lower than those in control group;the doses of analgesic drugs used and times of emergent rescue analgesia of the patients in experiment group were significantly lower than those in control group (P =0.000,P =0.029);the anus exhaust time after operation was significantly earlier than that in control group (P =0.030);the cases of nausea of the patients in experiment group were significantly lower than that in control group (P =0.023), and there were no significantly differences in the other various adverse effects of the patients between two groups (P >0.05).Conclusion: Oxycodone combined with dexmedetomidine is effective and safe for the postoperative analgesia after laparoscopic radical surgery of colon cancer.

Objective:To investigate the mainstream view and statusof people on body donation in Yunnan province, and provide references. Methods:Random sampling questionnaire survey was used, the obtained data was statistically analyzed. Results:Only 48. 0% of the people understand the body donation, 20. 6% of people know body donation ways and procedures, 27. 8% of people have heard of body receiving station, 11. 4% of people know the body receiving station in yunnan province, 17. 2% of the people to understand body donation of relevant laws and regulations. 47. 4% of people that are willing to donate his body. Conclusion:Make perfect laws and reg-ulations, respect for the body, giving donors and their families allowance, body donation monument, to carry out education and publicity of the body donation form to the whole society support and participate in the good atmos-phere of body donation has great benefits.

Prominent problems of clinical teaching in Tibet University school of medicine were analyzed and countermeasures were proposed from aspects of management system construction, facul-ty construction, curriculum construction, base construction and quality evaluation system construction. The aim was to increase students' opportunity, enhance students' learning interest and improve stu-dents' ability of analysis and problem solving so as to improve the practical effects of clinical teaching. All countermeasures taken above laid the foundation for future clinical work and provided help for clinical medical personnel in Tibetan border areas.

Objective To understand the mainstream view of ethnic minorities and Han nationality in Yunnan province on Body donation, understand the present status and possible issues about body donation in Yunnan province, so as to provide reference for Yunnan province on body donation. Methods We conducted questionnaire survey by random sampling. Results Yi,Dai,Han on the body donation knowledge and Donation rate was low,and the Yi, Dai was lower than Han.promoting development of medicineandthat is the continuation of lifebecame the main factors affecting the willing to donate body,there was significant difference between the three ethnic groups ( <0.05) .After death should be laid to rest,family and public pressure,fear of being free to use,religious beliefbecome the main factors affecting the unwilling to donate body, three nations also had significant difference ( <0.05) .Conclusions Most people think that the whole society should pay close attention to body donation, that body donation is a very meaningful thing. Joint effort should be made by both the government and civil society for body donation programs in Yunnan Province.