Objective:To evaluate the clinical efficacy of omalizumab in the treatment of patients with chronic spontaneous urticaria accompanied by other allergic diseases.Methods:Clinical data were retrospectively collected from 74 patients, who were clinically diagnosed with chronic spontaneous urticaria and other allergic diseases, and received subcutaneous injections of omalizumab in the Department of Allergy, Tianjin Medical University General Hospital from June 2020 to September 2022. Types of allergic diseases, serum total IgE (tIgE) and allergen-specific IgE (sIgE) levels before treatment, treatment outcomes and adverse drug reactions were analyzed. Differences before and after treatment were assessed using paired t-test and Wilcoxon signed-rank sum test. Results:A total of 74 patients with chronic spontaneous urticaria were involved, including 29 with complicated allergic asthma (39.2%) , 61 with complicated allergic rhinitis (82.4%) , 6 with complicated atopic dermatitis (8.1%) , and 4 with food allergy (5.4%) . Before treatment, elevated serum tIgE or sIgE levels were observed in 44 (59.5%) patients. After the first omalizumab treatment, the urticaria control test (UCT) score significantly increased compared with that before treatment (16.00 [13.0.0, 16.00] vs. 6.00 [5.75, 9.00], Z = 7.39, P < 0.001) ; after 4 sessions of the omalizumab treatment, 82.5% (33/40) of the patients achieved complete control of urticaria symptoms or showed complete response. After omalizumab treatment, asthmatic attacks were decreased in 29 patients with allergic asthma, and asthma control test (ACT) scores significantly increased compared with those before treatment (21.07 ± 2.88 points [after the first treatment] vs. 18.48 ± 3.20 points [before treatment], t = 8.87, P < 0.001) ; among 61 patients with allergic rhinitis, global rhinitis symptom-based visual analog scale (VAS) scores (before treatment: 5.89 ± 1.29 points; after the first treatment: 3.28 ±1.46 points) and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores (before treatment: 60.10 ± 20.53 points; after the first treatment: 37.26 ± 18.83 points) both significantly decreased after the first treatment ( t = 15.04, 10.01, respectively, both P < 0.001) , and rhinitis symptoms were relieved at the same time; skin itching was relieved in 4 patients with atopic dermatitis, and allergic symptoms after contact with food allergens were also relieved in the 2 patients with food allergy after omalizumab treatment. During the treatment, only 1 patient experienced erythematous swelling, induration, and pain at the injection site. Conclusions:In the treatment of chronic spontaneous urticaria accompanied by allergic diseases, the use of omalizumab not only effectively improved urticaria symptoms, but also well controlled allergic diseases, with a good safety profile. Multiple benefits may be achieved by the use of omalizumabin in patients with chronic spontaneous urticaria accompanied by other allergic diseases.

Objective:To investigate the value of visceral fat index (VAI) and lipid accumulation product (LAP) on predicting metabolic associated fatty liver disease (MAFLD) in the population without overweight/obesity.Methods:This study is a cross-sectional study. The physical examination data derived from International Physical Examination and Health Center of the Second Affiliated Hospital of Harbin Medical University from January to December 2021 were collected. According to the inclusion and exclusion criteria, a total of 4 304 subjects without overweight/obesity aged from 18-75 were included in this study. The subjects were divided into two groups with MAFLD or without MAFLD, according to the diagnostic criteria of MAFLD provided by The Asian Pacific Association for the Study of the liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease. Comparison of the clinical parameters (blood pressure, lipid, glucose) and obesity measurement indexes (BMI, VAI, LAP) between the two groups was analyzed. All subjects were respectively divided into four groups according to BMI, VAI and LAP quartile, which were defined as A, B, C, D. The prevalence of MAFLD in the population without overweight/obesity in quartile area groups of different obesity measurement indexes was calculated. Spearman′s rank correlation was used to evaluate the correlation between BMI, LAP, VAI and MAFLD in the population without overweight/obesity, respectively. Meanwhile, receiver operating characteristics (ROC) curves were used to calculate area under the curve (AUC) and evaluate the accuracy of BMI, VAI and LAP on predicting for MAFLD in the population without overweight/obesity.Results:The prevalence of MAFLD in the population without overweight/obesity was 10.87%. In the population without overweight/obesity, the clinical data blood pressure, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and fasting plasma glucose (FPG) in the group with MAFLD were significantly higher than those of the group without MAFLD (131/80 vs 113/70 mmHg, 5.29 vs 4.65 mmol/L, 3.21 vs 2.75 mmol/L, 1.87 vs 0.89 mmol/L, 5.60 vs 4.95 mmol/L; P<0.001), but high density lipoprotein cholesterol (HDL-C) of the group with MAFLD was significantly lower than that of the group without MAFLD (1.19 vs 1.49 mmol/L; P<0.001). The obesity measurement indexes (BMI, VAI, LAP) in the group with MAFLD were significantly higher than those of the group without MAFLD (22.10 vs 20.70 kg/m 2, 2.64 vs 1.00, 36.27 vs 12.48; all P<0.001). In the population without overweight/obesity, the prevalence of MAFLD was increased with the increase of BMI, VAI and LAP quartile area, and there was a linear correlation between MAFLD and obesity measurement indexes above. Spearman′s rank correlation analysis showed that correlation coefficient between obesity measurement indexes and MAFLD in the population without overweight/obesity was respectively LAP (0.427)>VAI (0.406)>BMI (0.282). ROC curve analysis showed that in the population without overweight/obesity, LAP had the highest accuracy on predicting MAFLD, with the AUC value of 0.896 (0.886-0.905), the optional cut-off value was 20.75, sensitivity and specificity was 85.9% and 79.0%, respectively. VAI (0.876) took the second place and BMI (0.761) located lastly. Conclusions:Both VAI and LAP have good prediction ability for MAFLD in the population without overweight/obesity. However, compared with VAI, LAP has higher accuracy on predicting MAFLD in the population without overweight/obesity.

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

Objective:To investigate the prevalence and independent risk factors of non-alcoholic fatty liver disease (NAFLD) and advanced chronic liver disease among the type 2 diabetes mellitus (T2DM) population in the Shenyang community, so as to provide evidence for the prevention and control of T2DM combined with NAFLD.Methods:This cross-sectional study was conducted in July 2021. 644 T2DM cases from 13 communities in Heping District, Shenyang City were selected. All the surveyed subjects underwent physical examination (measurements of height, body mass index, neck circumference, waist circumference, abdominal circumference, hip circumference, and blood pressure), infection screening (excluding hepatitis B and C, AIDS, and syphilis), random fingertip blood glucose, controlled attenuation parameter (CAP), and liver stiffness measurement (LSM). The study subjects were divided into the non-advanced chronic liver disease group and the advanced chronic liver disease group according to whether the LSM value was greater than 10 kPa. Cirrhotic portal hypertension development was indicated in patients with LSM ≥ 15 kPa. The comparison of multiple mean values among the sample groups was performed by analysis of variance when the normal distribution was met.Results:In the T2DM community population, there were 401 cases (62.27%) combined with NAFLD, 63 cases (9.78%) combined with advanced chronic liver disease, and 14 cases (2.17%) combined with portal hypertension. There were 581 cases in the non-advanced chronic liver disease group and 63 cases (9.78%) in the advanced chronic liver disease group (LSM ≥10 kPa), including 49 cases (7.61%) with 10 kPa≤LSM<15 kPa, 11 cases (1.71%) with 15 kPa ≤LSM<25 kPa, and 3 cases (0.47%) with LSM ≥ 25 kPa. Age, body mass, body mass index, neck circumference, waist circumference, hip circumference, waist-to-height ratio, systolic blood pressure, and CAP were all statistically different between the non-advanced chronic liver disease group and the advanced chronic liver disease group ( F=-1.983,-2.598,-4.091,-2.062,-3.909, -4.581,-4.295,-2.474, and -5.191, respectively; P<0.05). There was a statistically significant difference in terms of whether or not there was combined cerebrovascular disease (2=4.632, P=0.031); however, there were no statistically significant differences in terms of lifestyle, diabetes complications, and other complications ( P>0.05). Conclusion:Patients with T2DM have a higher prevalence of NAFLD (62.27%) than those with advanced chronic liver disease (9.78%). 2.17% of T2DM cases in the community may not have had early diagnosis and early intervention, and they might have been combined with cirrhotic portal hypertension. So, the management of these patients should be strengthened.

Objective To optimize the clinical managements of primary fetal hydrothorax(PFHT) fetus by comparing the perinatal survival rate of different prenatal treatments.Methods Totally 13 fetuses diagnosed with PFHT from July 2009 to December 2015 in the First Affiliated Hospital of Jinan University were collected and received prenatal expectant treatment, thoracocentesis (TC), and thoraco-amniotic shunting (TAS), respectively. The perinatal survival rate was compared among the three treatments. Results Among 13 fetuses of PFHT,pleural effusion was absorbed or remained stable in 2(2/13)cases,and progressed in 11(11/13) cases. Six cases received expectant treatment (2 cases had termination of pregnancy due to progressing effusion, 2 cases had term delivery, and 2 cases had intrauterine death); the perinatal survival rate was 2/6. Six cases received TC (2 cases had term delivery, 2 cases had preterm delivery,and 2 cases had termination of pregnancy due to progressing effusion),the perinatal survival rate was 4/6.One case received TC+TAS(term delivery),the perinatal survival rate was 1/1.The overall perinatal survival rate of prenatal intrauterine intervention was 5/7. Conclusions The clinical process of PFHT is changeable, and the pleural effusion will progress with gestational age. Intrauterine interventions could improve the perinatal survival rate.

OBJECTIVE:To promote the safe use of Heparin sodium injection for children. METHODS:According to litera-ture retrieve,questionnaire survey and field investigation,Health care failure mode and effect analysis method(HFMEA)was ad-opted to search for the failure modes of Heparin sodium injection for children,and preventive strategies were established and imple-mented based on these failure modes. Its effects were evaluated by comparing the error rate and risk priority number rating (RPN value)before and after the implementation. RESULTS:Totally 5 risk points of Heparin sodium injection requiring immediate inter-vention were obtained from RPN value,including wrong dose of Heparin sodium injection in prescribing,pharmacists'unclearness for the calculation method of the dose of Heparin sodium injection in dispensing,and nurses'no performing of double check sys-tem before infusion in administration,etc. After implementing related countermeasures,related error of Heparin sodium injection was decreased from 8 cases to 1 case,and error rate was declined from 3.76% to 0.51%(P<0.01). The RPN values of 5 failure modes were decreased from 112.08,91.56,115.78,94.52,99.23 to 28.02,23.91,27.71,23.63,20.55,respectively. CONCLU-SIONS:HFMEA can prospectively conduct systematical analysis for Heparin sodium injection for children. Implementing related countermeasures based on the current situation of our hospital can reduce the related error of Heparin sodium injection and promote the medication safety of children.

Objective To investigate the inhibitory effect of cryptotanshinone on different maturation stages of Staphylococcus epidermidis (S.epidermidis) biofilm.Methods The biofilm model of S.epidermidis was constructed in vitro, the timing of adhesion, accumulating, and maturation was determined;matrix quantity, bacterial metabolism, microstructure of biofilm were detected with semi-quantitative adhesion test, XTT assay, and scanning electron microscope(SEM) respectively.Results The timing of adhesion, accumulating, and maturation of S.epidermidis biofilm were 6h, 24h,and 48h respectively;in adhesion period, cryptotanshinone at the concentration of 128μg/mL and 32μg/mL could both obviously reduce the matrix and kill bacteria inside biofilm, difference was statistically significant(P<0.05),inhibitory effect of 128μg/mL cryptotanshinone was better than 32μg/mL (P<0.05), the microstructure was destroyed by both concentrations.During accumulating and mature period, only cryptotanshinone at 128μg/mL could reduce the matrix of biofilm and kill bacteria inside biofilm (P<0.05), the microstructure was damaged by cryptotanshinone at concentration of 128μg/mL, while 32g/mL of cryptotanshinone had no obvious inhibitory effect(P>0.05).Conclusion Cryptotanshinone has a certain inhibitory effect on different stages of S.epidermidis biofilm, and there is a certain dose effect.

OBJECTIVETo investigate the prenatal application of single nucleotide polymorphism array (SNP array) in the identification of 5p deletion syndrome with partial trisomy 11q.

METHODSG-banded karyotyping and SNP array were performed using amniocytes on a fetus with multiple malformations for the identification of chromosome abnormality. Furthermore, karyotyping was carried out on the parental peripheral blood specimens to ascertain the origin of chromosome abnormalities and then fluorescence in situ hybridization (FISH) was also utilized to confirm the results.

RESULTSKaryotype of amniocyte showed 46, XY, der(5) (?::p15 → qter). SNP array revealed a 13.907 Mb deletion at 5p15.33p15.2 (chr5: 113576-14020561), overlapping the region of 5p deletion syndrome, and a 18.254 Mb duplication at 11q23.3 q25 (chr11: 116684627-134938470), overlapping no known syndrome. Karyotype of the parents showed a normal 46,XX in mother and 46,XY,t(5;11)(p15;q23) in father. Three-color metaphase FISH analysis on paternal peripheral blood specimens also confirmed the paternal karyotyping result.

CONCLUSIONSNP array could uncover 5p deletion syndrome with partial trisomy 11q unidentified by G-banded karyotyping and accurately locate the genomic breakpoints, facilitating the mapping of pathogenic critical regions and the identification of candidate genes, also accumulating research data for genotype-phenotype study.

Adult ; Chromosome Banding ; Chromosome Deletion ; Chromosome Disorders ; diagnosis ; embryology ; genetics ; Chromosomes, Human, Pair 11 ; genetics ; Chromosomes, Human, Pair 5 ; genetics ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Male ; Oligonucleotide Array Sequence Analysis ; methods ; Polymorphism, Single Nucleotide ; Pregnancy ; Prenatal Diagnosis ; methods ; Trisomy ; diagnosis ; genetics

Objective To understand the distribution and drug resistance of pathogens causing catheter related bloodstream in‐fection (CRBSI) to provide reference for clinical treatment .Methods The distribution and drug resistance of pathogens isolated from the central venous catheter from January 2011 to June 2015 were retrospectively analyzed .Results Among 731 submitted samples ,38 cases were CRBSI ,with the positive rate of 5 .3% ,in which ,the Gram‐positive cocci accouted for 26 .3% of isolated bacteria and dominated by Staphylococcus epidermidis (13 .2% ) ,moreover which was MRSE .MRSA and VRE were not detected . Gram‐negative bacilli accounted for 73 .7% of isolated bacteria and dominated by Acinetobacter baumannii (42 .1% ) ,which was most sensitive to amikacin with the sensitivity rate of 87 .5% .Conclusion Acinetobacter baumannii is most common pathogen in CRBSI with serious drug resistance ,therefore the operating should be standardized in clinical work for controlling infection .

Objective To screen for clopidogrel metabolism related gene CYP2C19 in patients with coronary artery disease in Wuhan.Methods 316 patients,from Jan to Dec 2014,after cardiology percutaneous coronary interventional therapy (PCI) for the treatment of coronary artery disease were selected as research object.Clopidogrel metabolism related CYP2C19 geno-types (* 1,* 2,* 3)were detected by the gene chip,and for different types of metabolism of patients according to CYP2C19 gene type:strong metabolize type (*1/*1),intermediate metabolizer types (*1/*2,*1/*3),poor metaboli-zer types (*2/*2,*3/*3,*2/*3).Results According to the CYP2C19 gene polymorphism of metabolic function type, strong metabolic type carrying CYP2C19*1 (*1/*1)accounted was 43.4%,intermediate metabolizers carrying CYP2C19*2 or *3 (* 1/* 2 and * 1/* 3)and poor metabolizers (* 2/* 2,* 2/* 3 and * 3/* 3)accounted was 42.4% and 14.2%,respectively.Different gender had no statistical significance in CYP2C19 genotype differences.Conclusion Clopi-dogrel metabolism functional of CYP2C19 gene in patients with interventional coronary heart disease in Wuhan area had more deletion gene.