Objective:To assess the clinical effectiveness and safety of Omalizumab for treating pediatric allergic asthma in real world in China.Methods:The clinical data of children aged 6 to 11 years with allergic asthma who received Omalizumab treatment in 17 hospitals in China between July 6, 2018 and September 30, 2020 were retrospectively analyzed.Such information as the demographic characteristics, allergic history, family history, total immunoglobulin E (IgE) levels, specific IgE levels, skin prick test, exhaled nitric oxide (FeNO) levels, eosinophil (EOS) counts, and comorbidities at baseline were collected.Descriptive analysis of the Omalizumab treatment mode was made, and the difference in the first dose, injection frequency and course of treatment between the Omalizumab treatment mode and the mode recommended in the instruction was investigated.Global Evaluation of Treatment Effectiveness (GETE) analysis was made after Omalizumab treatment.The moderate-to-severe asthma exacerbation rate, inhaled corticosteroid (ICS) dose, lung functions were compared before and after Omalizumab treatment.Changes in the Childhood Asthma Control Test (C-ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) results from baseline to 4, 8, 12, 16, 24, and 52 weeks after Omalizumab treatment were studied.The commodity improvement was assessed.The adverse event (AE) and serious adverse event (SAE) were analyzed for the evaluation of Omalizumab treatment safety.The difference in the annual rate of moderate-to-severe asthma exacerbation and ICS reduction was investigated by using t test.The significance level was set to 0.05.Other parameters were all subject to descriptive analysis.A total of 200 allergic asthma patients were enrolled, including 75.5% ( n=151) males and 24.5% ( n=49) females.The patients aged (8.20±1.81) years. Results:The median total IgE level of the 200 patients was 513.5 (24.4-11 600.0) IU/mL.Their median treatment time with Omalizumab was 112 (1-666) days.Their first dose of Omalizumab was 300 (150-600) mg.Of the 200 cases, 114 cases (57.0%) followed the first Omalizumab dosage recommended in the instruction.After 4-6 months of Omalizumab treatment, 88.5% of the patients enrolled ( n=117) responded to Omalizumab.After 4 weeks of treatment with Omalizumab, asthma was well-controlled, with an increased C-ACT score [from (22.70±3.70) points to (18.90±3.74) points at baseline]. Four-six months after Omalizumab administration, the annual rate of moderate-to-severe asthma exacerbation had a reduction of (2.00±5.68) per patient year( t=4.702 5, P<0.001), the median ICS daily dose was lowered [0 (0-240) μg vs. 160 (50-4 000) μg at baseline] ( P<0.001), the PAQLQ score was improved [(154.90±8.57) points vs. (122.80±27.15) points at baseline], and the forced expiratory volume in one second % predicted (FEV 1%pred) was increased [(92.80±10.50)% vs. (89.70±18.17)% at baseline]. In patients with available evaluations for comorbidities, including allergic rhinitis, atopic dermatitis or eczema, urticaria, allergic conjunctivitis and sinusitis, 92.8%-100.0% showed improved symptoms.A total of 124 AE were reported in 58 (29.0%) of the 200 patients, and the annual incidence was 0(0-15.1) per patient year.In 53 patients who suffered AE, 44 patients (83.0%) and 9 patients (17.0%) reported mild and moderate AE, respectively.No severe AE were observed in patients.The annual incidence of SAE was 0(0-1.9) per patient year.Most common drug-related AE were abdominal pain (2 patients, 1.0%) and fever (2 patients, 1.0%). No patient withdrew Omalizumab due to AE. Conclusions:Omalizumab shows good effectiveness and safety for the treatment of asthma in children.It can reduce the moderate-to-severe asthma exacerbation rate, reduce the ICS dose, improve asthma control levels, and improve lung functions and quality of life of patients.

Objective:To investigate the influence of the teaching model based on the synergy of medical education on the objective structured clinical examination (OSCE) scores and critical thinking ability of interns in emergency department.Methods:A total of 84 students who studied as interns in Emergency Department of our hospital from January 2020 to 2021 were selected as research subjects, and they were divided into observation group and control group using a random number table, with 42 students in each group. The students in the control group were taught using traditional methods, while those in the observation group were taught based on the synergy of medical education. Both groups received an OSCE examination, and the two groups were compared in terms of OSCE score, critical thinking ability, and evaluation of teaching. SPSS 22.0 was used to perform the t-test and the chi-square test. Results:Compared with the control group, the observation group had significantly higher scores of theoretical assessment, disease assessment, first aid measures, special skills, use of medical instruments, communication skills with SP, and medical record writing and a significantly higher total score of OSCE assessment ( P<0.05). After teaching, both groups had a significant increase in the score of critical thinking ability, and the observation group had a significantly higher score than the control group [(306.38±25.76) vs. (280.39±20.17)]. The observation group had a significantly higher degree of satisfaction with teaching than the control group ( P<0.05). Conclusion:The teaching model based on the synergy of medical education can improve the OSCE score of interns in emergency department and cultivate their critical thinking ability, and there is a relatively high degree of satisfaction with this teaching model.

Twenty-two items of national criteria of acupuncture-moxibustion operation standardization have been issued by the People’s Republic of China. To understand the situation of use of these criteria, the authors analyzed and studied the situation of application of acupuncture-moxibustion criteria in related papers, textbooks and monographs to provide a basis for further establishing and revising the criteria. The results show that people are building awareness of use of acupuncture-moxibustion criteria, and the criteria have gradually been used in more and more papers, textbooks and works.

Objective: To observe the effect of tolvaptan on treating the patients with intractable heart failure (HF) combining hyponatremia for their clinical conditions and improvements. Methods: A total of 100 relevant patients treated in our hospital from 2014-01 to 2015-01 were studied. Based on conventional treatment as cardiac stimulant, dieresis and correction of electrolyte disturbance, the patients were randomly divided into 2 groups: Tolvaptan group, the patients received tolvaptan15 mg/d for 5 days and Control group, the patients had no tolvaptan administration.n=50 in each group. The improvement of clinical symptoms, changes of cardiac, renal functions and blood levels of electrolyte were compared between 2 groups after treatment. Results:① Compared with Control group, Tolvaptan group had significantly improved dyspnea, reduced lung moist rale and low limb edemaP<0.01; Tolvaptan group showed increased 24 h urine volume (2416.0±771.6 vs 1124.6±215.7) ml,P<0.01, decreased plasma levels of NT-proBNP (2678.04 ± 537.09) pg/ml vs (4051.34 ± 306.07) pg/ml,P<0.01 and increased blood levels of sodium (139.08 ± 6.18) mmol/L vs (129.44 ± 2.20) mmol/L,P<0.01. ②In Tolvaptan group, the above improvements were found in 38 patients, and with 1 day tolvaptan therapy, their blood nitrogen dropped from (10.39 ± 1.23) mmol/L to (7.28 ± 1.53) mmol/L,P<0.01; the other 12 patients had no such effect, and with 1 day tolvaptan therapy, their blood nitrogen elevated from (10.39±1.23) mmol/L to (13.38 ± 0.66) mmol/L,P<0.01. Conclusion: Tolvaptan could effectively improve clinical symptom and cardiac function in patients with intractable HF, it is helpful to increase blood sodium level; the efifcacy of tolvaptan might be evaluated by the changes of blood nitrogen at the early stage of treatment.

Objective To detect the serum levels of carbohydrate antigen 199(CA199),carbohydrate antigen 125 (CA125)and carcino-embryonic antigen(CEA)in different population,and to explore their significances in diagnosis of pancreatic cancer.Methods The serum levels of CA199,CA125 and CEA in 56 patients with pancreatic cancer (pancreatic cancer group ), 5 6 patients with benign pancreatic disease (benign pancreatic disease group ) and 56 healthy volunteers(normal control group)were detected,then the positive rates of CA199,CA125 and CEA and the sensitivities and specificities of CA199,CEA and CA125 for the diagnosis of pancreatic cancer were compared among three groups.Results The levels of serum CA199,CA125 and CEA of the patients in pancreatic cancer group were significantly higher than those in benign pancreatic disease group and normal control group (P<0.05). The positive rates of CA199,CEA and CA125 in pancreatic cancer group were 87.50 %,71.42%,and 60.71%, respectively. The positive rates of the three tumor markers of the patients in pancreatic cancer group were obviously higher than those in other two groups (P<0.05).The sensitivity of CA199(87.50%)was the highest,while the specificity of CEA (9 1.9 6%)was the highest. The method of parallel combined testing increased the diagnostic sensitivity to 95.12% and negative predictive value to 90.47%,but its specificity and the positive predictive value were decreased. Serial combined examination increased the diagnostic specificity to 92.86% and the positive predictive value to 89.19%,but its sensitivity and negative predictive value were decreased.Conclusion Combined detection of serum levels of CA199,CA125 and CEA has higher sensitivity and specificity than single-marker detection in the diagnosis of pancreatic cancer.