OBJECTIVE To standardize the rational clinical use of romosozumab in China， define suitable patient populations， optimize full-course treatment strategies， and strengthen medication risk management.METHODS This consensus was initiated by the Pharmacy Administration Committee of Guangdong Province Hospital Association and registered on the International Practice Guidelines Registry Platform. Twenty-five experts in pharmacy and orthopedics were organized to identify 7 core clinical questions through 2 rounds of questionnaires and seminars. Chinese and English databases were systematically retrieved， and the Grading of Recommendations Assessment， Development and Evaluation approach was used to assess evidence quality and recommendation strength and to formulate consensus recommendations， which were refined based on expert review.RESULTS Seven recommendations were developed， covering the applicable populations of romosozumab， sequential and switching therapy， and management of fractures and cardiovascular risk during treatment. The pharmaceutical characteristics of romosozumab， as well as other key points for clinical application， including efficacy monitoring， management of missed doses， contraindications， major adverse reactions， and medication adherence， were also summarized.CONCLUSIONS This consensus provides evidence-based guidance and practical reference for the safe， effective， and standardized use of romosozumab in Chinese patients， which may facilitate individualized treatment of patients with osteoporosis at high fracture risk and reduce fracture risk.

Objective To explore the mechanism of the effect of itraconazole ethanolamine tablets on the CD40/CD40L axis in children with idiopathic thrombocytopenic purpura(ITP).Methods 80 children with ITP were selected as the study subjects.They were divided into a control group(n=40)and a study group(n=40)using a digital random table method.The control group was treated with cyclosporine,while the study group was treated with itraconazole ethanolamine tablets.Both groups were treated continuously for 3 months.Compare the clinical efficacy of two groups of patients T lymphocyte subpopulation levels[CD3+CD4+and CD4+/CD8+,as well as adverse reactions.Detect CD40 on the surface of lymphocyte membrane and platelet membrane in two groups of patients CD40L level,plasma sCD40 and sCD40L levels were detected using ELISA.Results The total effective rate of the study group(92.50%)was significantly higher than that of the control group(75.00%)(P<0.05).CD3+CD4+,CD4+/CD8+,The expression levels of sCD40 in plasma were higher than before treatment,CD8+and peripheral blood CD19+CD40+The expression levels of CD3+,CD40L+cells,and plasma sCD40L were lower than before treatment;Research group CD3+CD4+,CD4+/CD8+,The expression level of sCD40 in plasma was higher than that in the control group,CD8+,And peripheral blood CD19+CD40+The expression levels of CD3+CD40L+cells and plasma sCD40L were lower than those of the control group(P<0.05).The CD40L+cells on the surface of peripheral blood platelet membranes after two treatment groups were lower than before treatment;The CD40+on the surface of peripheral blood platelet membrane in the study group was higher than that in the control group,CD40L+cells were lower than those in the control group(P<0.05).The total adverse rate of the study group(15.00%)was lower than that of the control group(22.50%),but there was no significant difference between the two groups(P>0.05).Conclusion The treatment of ITP in children with eltrombopag olamine tablets has good clinical effi-cacy,regulates the level of T lymphocyte subsets,and is safe.

Objective: To explore the clinical outcome of advanced testicular nonseminomatous germ cell cancer patients undergoing post chemotherapy retroperitoneal lymph node dissection (PC-RPLND), and to analyze the relevant prognostic factors of lymph node pathological. Methods: A total of 43 consecutive testicular nonseminomatous germ cell cancer patients underwent PC-RPLND between March 2001 and December 2014 in Department of Urology at Sun Yat-sen University Cancer Center were retrospectively reviewed. The average age of the patients was (29.0±11.5) years (ranging from 12 to 58 years). Before PC-RPLND, 22 patients were classified as phase Ⅱ, while 21 were phase Ⅲ. Primary tumor histology revealed seminomatous elements in 19 cases, embryonal cell carcinoma in 22 cases, yolk sac tumor in 13 cases, chorionic carcinoma in 3 cases, mature teratomatous elements in 11 and immature teratomatous elements in 2 cases. Patients were treated with cisplatin-based chemotherapy after orchectomy and then underwent surgical resection of retroperitoneal lymph nodes.After PC-RPLND, all patients underwent a periodic review including the blood routine, biochemistry routine and computed tomography or ultrasonograph of the chest, the abdomen and the pelvis. The association of pathological data with patient′s clinic features and the correlations between molecular features detected with each other were assessed by the t test, χ² and Fisher′s exact test. Multivariate logistic regression were used to assess prognostic factors. Results: The median operative time was 278 minutes (ranging from 50 to 715 minutes). Median blood loss was 425 ml (ranging from 50 to 5 000 ml). Eight patients received blood transfusion intra-operatively, 2 patients underwent adjunctive surgical procedures, 4 patients developed ileus and 4 had an ascites chylosus following PC-RPLND, 1 patient had a postoperative hyperthermia and retrograde ejaculation was present in 10 patients. The transverse diameter of the residual tumor in patients ranged from 0.8 to 18.2 cm. Necrosis, teratoma and viable germ cell tumors were found in 15, 17 and 11 of all patients. The median follow-up time was 46 months (ranging from 6 to 169 months). There were 39 patients had no tumor recurrence, 7 patients were found recurrence after PC-RPLND, 5 died of malignant germ cell tumor. The normal serum lactate dehydrogenase (LDH) level before chemotherapy (HR=25.811, 95%CI: 0.678 to 982.624, P=0.017) and relative changes more than 50% in retroperitoneal lymph node size (HR=0.016, 95%CI: 0 to 0.698, P=0.032) were statistically significant prognostic factors of the presence of necrosis. Conclusions Since most residual masses are not sensitive to chemotherapy, PC-RPLND is still an essential part of the treatment of metastatic testicular nonseminomatous germ cell cancer. Patients with the normal serum LDH level before chemotherapy and a shrinkage of 50% or more in retroperitoneal mass have a considerably chance of having necrosis in the retroperitoneum resection. This may help to refine the selection of candidates for PC-RPLND.

AIM: To study the effects of Radix Saposhnikoviae(RL) and Feutus Trbuli(FI) used singly and combinedly on antagonizing type Ⅰ allergy,such as passive cutaneous anaphylaxis(PCA),released model from mast cell granules,Schulz-Dale respond. METHODS: Mouse and rat models mainly induced by IgE were used in experiments. RESULTS: RL and FI used singly and combinedly could significantly inhibit PCA of same species of mice,the degranulation of mast cells of skull in rats and Schulz-Dale response. CONCLUSION: Both RL and FI respectively have antagonistic effect on type Ⅰ allergy and RL in combination with FI will possess more satisactory effect

Objective: To study the pharmacological effects of Radix Saposhnikoviae (RL) and Fruetus Tribuli (FI) used singly and combinedly. Methods: The effect of the tested drugs on the animal itching models induced by dextran 40 and Histanmine, skin capillary permeability induced by Histamine and experimental nettle rash induced by dimethylsulfoxide (DMSO) were observed. Results: RL and FI used singly and combinedly could obviously relieve the itch, inhibit the increase of skin capillary permeability induced by Histamine and resist experimental nettle rash induced by dimethylsulfoxide (DMSO) in different degree. Conclusion:RL and FI used singly and combinedly have anti allergic effect and the effect of RL and FI used combinedly is the same as used respectively.