Objective To investigate the clinical characteristics of lower respiratory tract infections oc-currence and respiratory system prognosis in infantile stage of children patients with bronchopulmonary dys-plasia(BPD).Methods Fifty premature infants with lower respiratory tract infection and BPD treated in this hospital from March 2017 to December 2020 were selected as the BPD group and 50 preterm infants with low-er respiratory tract infection without BPD during the same period were selected as the non-BPD group.The clinical data and occurrence situation of respiratory system diseases within 3 years after birth in the two groups were collected and analyzed.Results Compared with the non-BPD group,the incidence rates of tachy-pnoea(48.0%vs.12.0%),wheeze(44.0%vs.10.0%),wheezing rale(44.0%vs.10.0%),three concave sign(28.0%vs.8.0%),cyanosis(20.0%vs.4.0%),severe pneumonia(48.0%vs.12.0%)and respirato-ry failure(20.0%vs.4.0%)in the BPD group were higher,the hospitalization duration[7.5(7.0,10.0)d vs.7.0(6.0,7.0)d]was longer,the reaching peak time ratio[18.20%(14.65%,22.25%)vs.24.85%(19.55%,32.78%)],the reaching peak volume ratio[22.15%(19.43%,23.83%)vs.25.65%(22.40%,34.90%)]and the inspiratory/expiratory ratio(0.70±0.12 vs.0.76±0.11)were lower,the 3-year total lower respiratory tract infection times[5.0(4.0,10.0)times vs.3.0(2.0,5.0)times],wheeze times[2.0(1.0,4.0)times vs.0.5(0,1.0)times],the hospitalization times[3.00(2.00,5.00)times vs.2.00(1.00,2.00)times],severe pneumonia times[2.0(1.0,2.0)times vs.1.0(0,1.0)times]and wheeze times in differ-ent ages were more,total hospitalization duration[29.50(19.50,38.25)d vs.13.00(7.00,17.75)d]was lon-ger,the differences were statistically significant(P<0.05).Conclusion The children patients with BPD are prone to lower respiratory tract infections,especially 0-<1 years old,the proportion of severe pneumonia af-ter infection is higher and wheezing is easily to develop.

The research of damp-heat syndrome in modern TCM mainly focuses on inflammatory response, water metabolism, lipid metabolism, hemorheology, intestinal flora and so on. Modern omics techniques such as metabolomics and genomics provide a new perspective for the exploration of the micro-mechanism of damp-heat syndrome. The study found that the abnormal expression of aquaporin is closely related to the formation of "dampness" in damp-heat syndrome, and the release of inflammatory factors reflects the pathological characteristics of "heat". Damp-heat syndrome is often accompanied by dyslipidemia, hemorheological changes and intestinal flora imbalance, showing characteristic changes in urine, blood and saliva metabolomics, and there are differences in gene expression between damp-heat constitution and gentleness constitution. In the future, the pertinence and systematicness of research should be strengthened, the relationship between indicators should be deeply explored, build a biomarker system should be built, the immune-metabolic regulation mechanism should be explored, the multi-target mechanism of heat-clearing and dampness-removing Chinese materia medica should be clarified to further improve the damp-heat syndrome system, and provide theoretical support for clinical treatment.

BACKGROUND: This study aimed to determine the reasons for conversion and elucidate the safety and efficacy of transition to tenofovir alafenamide/emtricitabine/bictegravir sodium (TAF/FTC/BIC) in highly active antiretroviral therapy (HAART)-experienced HIV-infected patients in real-world settings. METHODS: We conducted a retrospective cohort study. The treatment conversion rationales, safety, and effectiveness in 1684 HIV-infected patients with previous HAART experience who switched to TAF/FTC/BIC were evaluated at Beijing Ditan Hospital from September 2021 to Auguest 2022. RESULTS: Regimen simplification (990/1684, 58.79%) was the most common reason for switching, followed by osteoporosis or osteopenia (375/1684, 22.27%), liver dysfunction (231/1684, 13.72%), decline in tenofovir alafenamide/emtricitabine/elvitegravir/cobicistat (TAF/FTC/EVG/c) with food restriction (215/1684, 12.77%), virological failure (116/1684, 6.89%), and renal dysfunction (90/1684, 5.34%). In patients receiving non-nucleotide reverse transcriptase inhibitors (NNRTI)-containing regimens, lipid panel changes 1 year after switching indicated a difference of 3.27 ± 1.10 mmol/L vs . 3.40 ± 1.59 mmol/L in triglyceride ( P  = 0.014), 4.82 ± 0.74 mmol/L vs . 4.88 ± 0.72 mmol/L in total cholesterol ( P  = 0.038), 3.09 ± 0.70 mmol/L vs . 3.18 ± 0.66 mmol/L in low-density lipoprotein ( P  <0.001), and 0.99 ± 0.11 mmol/L vs . 0.95 ± 0.10 mmol/L in high-density lipoprotein ( P  <0.001). Conversely, among patients receiving booster-containing regimens, including TAF/FTC/EVG/c and lopinavir/ritonavir (LPV/r), lipid panel changes presented decreased trends. We also observed an improved trend in viral load suppression, and alanine transaminase (ALT), aspartate transaminase (AST), estimated glomerular filtration rate (eGFR), and serum creatinine levels after the transition ( P  <0.001). CONCLUSION The transition to TAF/FTC/BIC demonstrated good treatment potency. Furthermore, this study elucidates the motivations behind the adoption of TAF/FTC/BIC in real-world scenarios, providing clinical evidence supporting the stable conversion to TAF/FTC/BIC for HAART-experienced patients.
Humans ; Antiretroviral Therapy, Highly Active/adverse effects* ; Anti-HIV Agents/adverse effects* ; HIV Infections/drug therapy* ; Tenofovir/therapeutic use* ; Retrospective Studies ; Emtricitabine/pharmacology* ; Adenine/therapeutic use* ; Lipids

OBJECTIVE To systematically evaluate the efficacy and safety of transcatheter arterial chemoembolization （TACE） combined with local ablation in the treatment of unresectable primary liver cancer （PLC）， and to provide evidence-based reference for rational clinical treatment. METHODS Retrieved from CNKI， Wanfang Data， VIP， PubMed， Embase， Cochrane Library， ClinicalTrials， Web of Science， Ovid and SinoMed， randomized controlled trial （RCT） about TACE combined with local ablation （trial group） versus TACE （control group） were collected. After screening the literature and extracting the data， the bias risk assessment tool recommended by the Cochrane System Evaluator Manual 5.1.0 was used to evaluate the quality of the included literature； Stata14.0 software was used for meta-analysis. RESULTS A total of 39 RCTs were included， including 2 294 patients， involving 6 interventions， i.e. TACE， TACE + radiofrequency ablation （RFA）， TACE + microwave ablation （MWA）， TACE + absolute ethanol injection （PEI）， TACE + cryoablation （CRA）， TACE + high-intensity ultrasound focused ablation （HIFU）， and 4 chemotherapeutic drugs， i.e. platinum， anthracycline， pyrimidine analogues， and polypeptides. The results of meta-analysis showed that in terms of objective remission rate， TACE+RFA， TACE+HIFU and TACE+MWA were higher； in terms of 1-year survival rate， TACE+PEI， TACE+HIFU and TACE+MWA were higher； in terms of 2-year survival rate， TACE+HIFU， TACE+MWA and TACE+PEI were higher； in terms of 3-year survival rate， TACE+HIFU， TACE+PEI and TACE+RFA were higher； in terms of security， TACE+MWA， TACE+RFA and TACE were 643295494@qq.com higher； there was no significant difference in the efficacy of 4 chemotherapeutic drugs in TACE+MWA （P＞0.05）. CONCLUSIONS For patients with unresectable PLC， TACE+ MWA has good efficacy and safety， which is the best combination； the 4 chemotherapeutic drugs in TACE+MWA are all effective， and suitable chemotherapeutic drugs can be selected individually.

OBJECTIVE：To improve the level of pharmaceutical care，enhance the professional value and social status of pharmacists by clarifying the development process of pharmaceutical care and summarizing the value of pharmacists in pharmaceutical care. METHODS：The development process of pharmaceutical care at home and abroad（service objects，service contents and service methods）was summarized；the current situation of pharmaceutical care in China was analyzed；the value of pharmaceutical care were defined in respects of rational drug use，humanistic value and medical resources. The development of pharmaceutical care in the future was prospected. RESULTS & CONCLUSIONS：The development of pharmaceutical care can be divided into three stages：“drug supply as the center”“promoting rational drug use as the center”and“patients as the center”，and the service objects，service contents and service methods in different stages are expanding and diversifying. Compared with developed countries，the overall level of pharmaceutical care in China lags behind，and there are differences in level of pharmaceutical care modes in hospitals at different levels. Pharmacists ensure the safety，effectiveness and economy of drug use through pharmaceutical care，and promote rational drug use；the compliance，quality of life and satisfaction of patients have been improved through pharmaceutical care；pharmacists participate in medical quality management to save medical and health resources through pharmaceutical care. Pharmaceutical care，as an important part of the medical and health system，plays an important and irreplaceable role in the medical process，which is suggested that the relevant government departments should fully understand the value of pharmaceutical care and further strengthen their support for pharmaceutical care；pharmaceutical staff should improve their self-cultivation and cooperate with other disciplines to achieve the sustainable development of hospital pharmacy in different regions and medical institutions.

Objective:To investigate the efficacy, safety and common adverse reactions of Apatinib monotherapy in elderly patients with advanced colorectal cancer(CRC)who failed to respond to standard regimens.Methods:This was a retrospective study.A total of 106 elderly patients with advanced CRC who had failed standard regimens from January 2015 to December 2019 were included.Patients enrolled in this study received Apatinib with an initial dosage of 500 mg or 250 mg.The objective response rate(ORR)and disease control rate(DCR)were assessed after treatment with apatinib.The progression-free survival(PFS)and overall survival(OS)were evaluated during the follow-up period.Additionally, adverse reactions during treatment with apatinib were recorded.Results:The efficacy was assessed by using the best overall response during apatinib treatment.Of 106 patients, there were 9 patients with partial response(PR), 68 patients with stable disease(SD)and 29 patients with progressive disease(PD). The ORR was 8.5% and the DCR was 72.6%.The median PFS was 3.6 months and the median OS was 10.1 months.Relatively common adverse reactions in these patients were hypertension(63 patients, 59.4%)and hand-foot syndrome(HFS)(51 patients, 48.1%)during apatinib treatment.The median PFS of patients with hypertension and of patients without hypertension were 5.0 months and 3.0 months, respectively( P=0.008). The median PFS of patients with and without HFS were 5.4 months and 3.0 months, respectively( P=0.013). Conclusions:Preliminary evidence suggests that Apatinib monotherapy has good efficacy and safety in elderly patients with advanced CRC who have failed standard regimens, and patients with adverse reactions such as hypertension and HSF still have a good prognosis.

OBJECTIVE：To systematically evaluate the efficacy an d s afety of apatinib combined with transcatheter arterial chemoembolization（TACE）in the treatment of moderate and advanced liver cancer ，and to provide evidence-based reference for rational drug use in the clinic. METHODS ：Retrieved from Cochrane Library ，Embase，PubMed，Web of Science ，SinoMed， CNKI，Wanfang，VIP database ，RCTs about apatinib combined with TACE （trial group ）versus TACE （control group ）in the treatment of moderate and advanced liver cancer were collected from inception to Sep. 2019. After screening the literature and extracting the data ，the quality of included literatures was evaluated by using bias risk assessment tool recommended by the Cochrane system evaluator manual 5.1.0 and the modified Jadad scale. Meta-analysis was carried out by using Stata 12.0 software. RESULTS：Totally 16 RCTs were included ，involving 1 043 patients. Results of Meta-analysis showed that objective response rate [OR ＝3.10，95％CI（2.38，4.03），P＜0.001]，disease control rate [OR ＝3.56，95％CI（2.62，4.83），P＜0.001] and survival rate [OR ＝2.40，95％ CI（1.86，3.10），P＜0.001]，the incidence of diarrhea [OR ＝2.27，95％ CI（1.21，4.24），P＝0.011]， hypertension [OR ＝6.97，95％ CI（1.21，40.15），P＝0.030]， proteinuria [OR ＝12.44，95％CI（2.51，61.71），P＝0.002] and com hand foot syndrome [OR ＝32.50，95％CI（12.03，87.77），P＝ 0.001] of trial group were significantly higher than those of control group. The serum level of VEGF [SMD ＝－ 3.64， 95％CI（－5.06，－2.22），P＜0.001]，MMP-9 [SMD＝－3.21，95％CI（－4.31，－2.10），P＜0.001]，AFP [SMD ＝－3.54， 95％CI（－7.03，－0.06），P＝0.046] after treatment ，the incidence of myelosuppression [OR ＝0.61，95％CI（0.39，0.97），P＝ 0.035]，fever [OR ＝0.63，95％CI（0.42，0.95），P＝0.027]，nausea and vomiting [OR ＝0.70，95％CI（0.51，0.97），P＝0.030] in trial group were significantly lower than those of control group. There was no statistical significance in the incidence of abdominal pain [OR ＝0.87，95％CI（0.54，1.39），P＝0.547] and skin itching [OR ＝1.63，95％CI（0.36，7.50），P＝0.530] between 2 groups. CONCLUSIONS：Apatinib combined with TACE can significantly improve clinical efficacy ，prolong survival time ，reduce tumor recurrence and metastasis. It can reduce the occurrence of related ADR as diarrhea after TACE ，but increase the occurrence of apatinib-related ADR as myelosuppression.

Objective:Oral fluoropyrimidine S-1 contains tegafur,gimeracil,and oteracil;among them,tegafur is the major active pre-cursor,which is metabolized to 5-fluorouracil by cytochrome P4502A6(CYP2A6).We examined the associations between CYP2A6 poly-morphisms and the treatment outcomes of adjuvant S-1 in patients with gastric cancer.Methods:Two hundred patients diagnosed with pathological stageⅡ-Ⅲgastric cancer were included in this study,and they received adjuvant S-1(40 mg/m2,bid,days 1-28,ev-ery 6 weeks for eight cycles)after curative surgery.Additionally,we analyzed the wild-type allele(W)(CYP2A6*1)and four variant al-leles(V)(CYP2A6*4,*7,*9,and*10).Results:Two hundred patients were enrolled in this study between November 2007 and July 2013.With a median follow-up of 46.4 months(range:12.5-80.1),the 3-year relapse-free survival(RFS)and overall survival(OS)rates were 83.1%(95% confidence interval(CI),77.7%-88.5%)and 94.8%(95% CI,91.6%-98.0%),respectively.However,RFS differed signifi cantly according to the CYP2A6 genotype.The 3-year RFS rates were 95.9% for W/W,83.1% for W/V,and 72.5% for V/V(P=0.032)gen-otypes.Grades 3 and 4 overall toxicity did not differ according to genotype for any grade(P=0.628 and P=0.227,respectively).Conclu-sions:CYP2A6 genotypes correlate with the outcome of S-1 chemotherapy,wherein patients with the variant genotypes show worse prognosis.Additionally,polymorphism detection may be used as a biomarker to guide clinical chemotherapy choices for adjuvant ad-ministration of gastric cancer therapy.

[Abstract] Objective: To investigate the relationship between expression of MICA/B (MHC class I chain-related proteinA/B) and disease-free survival (DFS) of patients with HER2+(human epidermal growth factor receptor 2) breast cancer tissue. Methods: Twenty six cases of corresponding para-cancerous tissue and 100 cases of HER2+ breast cancer tissue that preserved in wax at Zhengzhou People’ s Hospital Affiliated to Southern Medical University from January 2009 to June 2010 were collected for this study. Expression of MICA/ B in these tissue samples was detected by immunohistochemistry; and the relationship between MICA/B expression with clinicopathologic features as well as DFS was analyzed with Kaplan-Meier survival curve. Results: The expression of MICA/B in adjacent paracancerous tissues was negative (0/26), however, it was highly positive in cancer tissues (92/100), and the percentage with high expression was 65%(65/100), the difference was significant (P<0.05). High MICA/B expression rate in stage I was significantly higher than that in stage Ⅱ-Ⅲ (77.55% vs 52.94%， P<0.05), and the high expression rate in stage T1 was also significantly higher than that in stage T2-T4 (75.00% vs 52.27%， P<0.05). High MICA/B expression rate in ER+, PR+ group (with positive number≥1%) was significantly lower than that in ER- , PR-group (ER： 52.38% vs 74.14%，PR： 51.35% vs 73.02%， all P<0.05). MICA/B expression was correlated with clinical stages, the expression of ER, PR and tumor size (all P<0.05), but not associated with menopausal status, histological grade and lymph node metastasis (all P>0.05). Over-expression of MICA/B was closely associated with much better 6-year DFS rate in patients no matter with or without targeted therapy (the targeted group: 90.6% vs 72.2%; the untargeted group: 78.4% vs 58.8%, all P<0.05). Conclusion: Over-expression of MICA/B in HER2+ breast cancer tissue is closely related to DFS, which may be served as a potential prognosis indicator for patients with HER2+ breast cancer.

Objective To investigate the lung ultrasonography characteristics of community acquired pneumonia ( CAP) in children and to compare the value of lung ultrasonography in the diagnosis of CAP in children. Methods A total of 173 patients with CAP ( CAP group) were diagnosed by chest radiograph in our hospital,and 64 healthy children were treated with lung ultrasonography as the control group. The sono-graphic features of two groups were compared,and the positive rates of diagnosis of lung ultrasonography and chest radiograph in CAP group were also compared. Results It showed A-line disappearance ( 100%) , B-line presence ( 88. 4%) , pleural line abnormalities ( 98. 3%) , pulmonary consolidation ( 46. 2%) , bronchial sign(42. 8%),pleural effusion(9. 2%),lung sliding signs(97. 7%) in CAP group (P<0. 001). In the con-trol group,except the A-line disappearance,scattered in the B-line (34. 4%),the others were not present. The difference of the two groups was statistically significant (P<0. 001). A-line disappearance,B-line (or even fusion) ,pleural line abnormalities were the main signs of ultrasound in children with CAP, sensitivity and specificity were both 100%. The sensitivity of chest X radiograph was 100% and the specificity was 78. 0%. Conclusion The lung ultrasonic imaging features of CAP in children include A-line disappearance, with varying numbers and lengths of B-line, pleural line abnormalities, consolidation, bronchial signs, pleural effusion and so on. LUS can diagnose CAP accurately and reliably,with high sensitivity and specificity. It is simple and noninvasive, and has the advantage of being detected at any time and avoiding the damage of X-ray. So it is worth clinical application for children with respiratory tract diseases.