Reflection and Practice on the Implementation of "Exemption from Ethical Review" in Medical Institutions / 中国医学伦理学

From the perspective of medical institutions, this paper sorted out the contents of Article 32 of the Measures for Ethical Review of Life Sciences and Medical Research Involving Human regarding "exemption from ethical review". At the same time, combined with domestic and foreign regulations, this paper deeply considered and analyzed the applicable premise and special circumstances of the provisions from the implementation level, and then put forward suggestions from the perspective of practical operation of medical institutions, with a view to providing some practical guidance and reference for ethical practitioners of medical institutions.

2011 to 2021 rehabilitation professionals distribution from system of China Disabled Persons' Federation using geographical gravity model / 中国康复理论与实践

ObjectiveTo investigate the distribution and trend of rehabilitation personnel of China Disabled Persons' Federation (CDPF) system and the people with disabilities (PWDs) using geographical gravity model. MethodsBased on ArcGIS and statistical data, the distribution of geographical center of gravity of the rehabilitation personnel of the CDPF system from 2011 to 2021 was analyzed. According to the economic development, the areas were divided into three regions, and the eastern region included eleven provincial units, the central region includes eight provincial units, and the western region included twelve provincial units. ResultsCompared with 2011, rehabilitation staffs per thousand PWDs increased at 107.5% in 2021, 81.1%, 114.2% and 174.1% for the eastern, central, and western regions, respectively; professional staffs increased at 190.5%, 148.8%, 284.6% and 280.6% for the eastern, central, and western regions, respectively; managerial staff increased at 80.0%, 46.8%, 554.3% and 128.1% for the eastern, central, and western regions, respectively. Compared with 2011, the geographical center of gravity of the rehabilitation personnel moved about 330.9 km in 2021, while the geographical center of gravity of the PWDs moved about 169.64 km. ConclusionThe rehabilitation personnel in the CDPF system is the most in the eastern region and least in the western region. The tracks of the geographical center of gravity of the three kind of rehabilitation personnel in the CDPF system are relatively consistent. The rehabilitation personnel in the eastern region are more concentrated than those in the western region, and the density of the PWDs is more westward than that of the rehabilitation personnel, and coordination is not a perfect match yet. It is necessary to strengthen the rehabilitation personnel allocation in the western region, to balance distribution of human resources for rehabilitation of PWDs among regions.

Meta-analysis of the efficacy and safety of Ilaprazole Enteric-Coated Tablets on reflux esophagitis / 药学实践杂志

Objective To evaluate the efficacy and safety of Ilaprazole Enteric-Coated Tablets in the treatment of RE. Methods The databases of CNKI, VIP, Wanfang Data, PubMed, Embase, and The Cochrane Library were searched to collect all the randomized controlled trials (RCTs) of Ilaprazole in the treatment of RE published before April 2021. After data extraction and quality evaluation, the RCTs meeting the inclusion criteria were performed, and the meta-analysis was conducted by RevMan 5.4. Results Nine RCTs were included, with a total of 1115 patients of RE. The results of the meta-analysis showed that Ilaprazole Enteric-Coated Tablets were comparable to Esomeprazole Enteric-Coated Tablets in both endoscopic efficiency (90.08% vs. 90.00%, P > 0.05) and symptom relief rates (91.79% vs. 91.23%, P > 0.05), and there was no statistically significant difference in the incidence of adverse reactions (7.99% vs. 8.66%, P > 0.05). Conclusion Ilaprazole Enteric-Coated Tablets with lower doses were comparable to Esomeprazole Enteric-Coated Tablets which showed good efficacy and safety in the treatment of reflux esophagitis.

Efficacy and safety of dupilumab in the treatment of 123 cases of atopic dermatitis / 中华皮肤科杂志

Objective:To investigate clinical efficacy and safety of dupilumab in the treatment of atopic dermatitis (AD) .Methods:An ambispective study was conducted on 123 AD patients treated with dupilumab in Department of Dermatology, the Second Xiangya Hospital of Central South University from July 2020 to March 2022, clinical data were collected, and efficacy and safety of dupilumab were evaluated. Primary outcomes included scores of eczema area and severity index (EASI) , patient-oriented eczema measure (POEM) , peak pruritus numerical rating scale (NRS) and dermatology life quality index (DLQI) before and after 4-, 8-, 12- and 16-week treatment, and adverse reactions and events were recorded. Comparison of scores before and after treatment was performed using paired t test or repeated measures analysis of variance, Mann-Whitney U test was used for the comparison of efficacy among patients with different types of skin lesions or different IgE levels, and multiple regression model based on robust standard errors was used to analyze factors influencing the efficacy. Results:Among the 123 AD patients, 107 were enolled into the efficacy analysis, and 85 (79.44%) completed at least 4 weeks of treatment, including 6 (7.06%) achieving EASI75 and 23 (27.06%) achieving EASI50, and the EASI, NRS, POEM, DLQI scores (10.41 ± 6.72, 4.12 ± 1.74, 8.60 ± 4.29, 7.81 ± 4.38, respectively) significantly decreased compared with those before treatment (18.08 ± 10.69, 7.21 ± 2.01, 16.88 ± 5.74, 12.95 ± 5.95, respectively; all P < 0.001) in the 85 patients. Among the 107 patients, 47 (43.93%) completed at least 16 weeks of treatment. Among the 47 patients, 23 (82.14%) of 28 adults and 17 (89.47%) of 19 adolescents and children achieved 75% or greater improvement in EASI score; the EASI, NRS, POEM and DLQI scores before the treatment all significantly differred from those 4, 8, 12, 16 weeks after the treatment (all P < 0.001) , and all the scores were significantly lower at weeks 4, 8, 12 and 16 than at the previous adjacent time points (all P < 0.05) . At week 4 during the treatment, the EASI improvement rate was significantly lower in the AD patients with prurigo nodularis than in those without ( U = 151.00, P = 0.006) , while there was no significant difference in the EASI improvement rate between the AD patients with xeroderma and those without ( P > 0.05) ; at week 16 during the treatment, there was no significant difference in the EASI improvement rate between patients with prurigo nodularis or xeroderma and those without (both P > 0.05) . Multiple regression analysis based on robust standard errors at week 16 showed that the improvement degree in the EASI score was not correlated with the type of skin lesions ( β = 3.20, P = 0.075) , but correlated with age ( β = -0.22, P = 0.030) , whether patients were in adulthood ( β = 9.54, P = 0.049) , immediate family history ( β = 7.46, P = 0.017) ; the improvement degree in the NRS score was correlated with the type of skin lesions ( β = 0.55, P = 0.032) , age ( β = -0.04, P = 0.033) , weight ( β = -0.05, P = 0.020) , whether patients were in adulthood ( β = 2.06, P = 0.003) and whether patients received combined treatment with antihistamines ( β = -1.91, P = 0.001) . Adverse reactions: among the 123 patients, 6 (4.88%) developed conjunctivitis, and 2 (1.63%) developed facial erythema. Adverse events: vitiligo-like changes occurred on the right forehead of 1 patient, and 3 patients discontinued the treatment with dupilumab due to Henoch-Sch?nlein purpura, distal axonal damage in peripheral nerves in both upper limbs, and epilepsy, respectively. The causal relationship between these adverse events and dupilumab was unclear. Conclusion:Dupilumab is effective in the treatment of AD with high overall safety, and can serve as a new treatment option for AD patients with an unsatisfactory response to traditional treatment.

Factors affecting postpartum stress urinary incontinence among lying-in women at ages of 35 years and older / 预防医学

Objective@#To investigate the factors affecting postpartum stress urinary incontinence (PSUI) among lying-in women at ages of 35 years and older, so as to provide insights into PSUI prevention. @*Methods@#Lying-in women at ages of 35 years and older receiving postpartum examinations were sampled using a convenient sampling method from Hangzhou Obstetrics and Gynecology Hospital during the period from January 2021 to April 2022. Participants' demographic data, type of delivery, birth weight, diastasis recti abdominis, pelvic floor muscle strength injury, pelvic floor muscle training were collected, and the development of PSUI was evaluated using the International Consultation on Incontinence modular questionnaire. The factors affecting the development of PSUI were identified among lying-in women at ages of 35 years and older using a multivariable logistic regression model. @*Results@#A total of 230 questionnaires were allocated, and 226 valid questionnaires were recovered, with an effective recovery rate of 98.26%. The lying-in women had a mean age of (37.30±2.11) years, and 75.66% had a pre-pregnancy body mass index (BMI) of 18.5 to 24.0 kg/m2. There were 29 women with postpartum BMI of 24.0 kg/m2 and greater (12.83%), 201 women with gestational weeks of 37 weeks and greater at delivery (88.94%), 105 women with vaginal delivery (46.46%), 20 women with neonatal birth weights of 4 000 g and higher (8.85%), 149 women with diastasis recti abdominis (65.93%), 154 women with pelvic floor muscle strength injury (68.14%). The prevalence of PSUI was 25.22% among the study subjects. Multivariable logistic regression analysis showed that vaginal delivery (OR=4.061, 95%CI: 2.124-7.763), postpartum BMI of 24 kg/m2 and higher (OR=1.903, 95%CI: 1.275-3.288), neonatal birth weight of 4 000 g and higher (OR=2.108, 95%CI: 1.420-4.135), diastasis recti abdominis (OR=1.487, 95%CI: 1.110-2.169) and pelvic floor muscle strength injury (OR=2.924, 95%CI: 1.726-4.803) were risk factors for PSUI among lying-in women at ages of 35 years and older, and pelvic floor muscle training was a protective factor for PSUI among lying-in women at ages of 35 years and older (OR=0.410, 95%CI: 0.216-0.780).@*Conclusions@#The development of PSUI correlates with the type of delivery, postpartum BMI, neonatal birth weight, diastasis recti abdominis and pelvic floor muscle strength injury among lying-in women. Reasonable weight control and active pelvic floor muscle training may facilitate the prevention of PSUI.

Factors affecting postmenopausal osteoporosis in Dali Bai Autonomous Prefecture / 预防医学

Objective@#To investigate the prevalence of postmenopausal osteoporosis (PMOP) and analyze its influencing factors among women at ages of 50 to 59 years in Dali Bai Autonomous Prefecture, Yunnan Province, so as to provide insights into the prevention of PMOP among menopausal women.@*Methods@#Bai Ethnic menopausal women at ages of 50 to 59 years who received healthy examination at the Center of Healthy Examination, Dali Prefecture People's Hospital from June 2017 to May 2021 were selected as the study subjects, and subjects' demographic characteristics, living habits, history of diseases, family history of osteoporosis and history of parturition were collected using self-designed questionnaires. The height, body weight and bone density were measured, and fasting blood glucose, vitamin D3, blood lipids and liver functions were detected. The factors affecting the development of PMOP were identified using a multivariable logistic regression model.@*Results@#Totally 2 000 questionnaires were allocated, and 1 584 valid questionnaires were recovered, with an effective recovery rate of 79.20%. The respondents had a mean age of ( 56.22±2.61 ) years, and mean body mass index ( BMI ) of ( 24.62±2.35 ) kg/m2. There were 497 respondents ( 31.38% ) with a family history of osteoporosis, and the prevalence of PMOP was 20.64%. Multivariable logistic regression analysis identified age ( OR=1.135, 95%CI: 1.074-1.196 ), age of menarche ( OR=1.138, 95%CI: 1.059-1.217 ), duration of menopause (OR=1.425, 95%CI: 1.228-1.622), number of parturition ( >2, OR=5.036, 95%CI: 2.972-7.101 ), smoking ( OR=2.594, 95%CI: 1.767- 3.421 ), alcohol consumption ( OR=2.051, 95%CI: 1.503-2.598 ), family history of osteoporosis ( OR=2.540, 95%CI: 1.769-3.311 ), hypertension ( OR=1.492, 95%CI: 1.406-1.578 ), diabetes ( OR=1.774, 95%CI: 1.581-1.967 ), total cholesterol ( OR=1.483, 95%CI: 1.251-1.716 ), triacylglycerol ( OR=1.801, 95%CI: 1.576-2.026 ), low-density lipoprotein cholesterol ( OR=1.614, 95%CI: 1.498-1.731 ), fasting blood glucose ( OR=1.192, 95%CI: 1.077-1.307 ), BMI ( OR=0.934, 95%CI: 0.862-0.993 ), outdoor activity ( ≥1 time/week, OR: 0.413-0.549, 95%CI: 0.329-0.637 ), age of menopause ( OR=0.909, 95%CI: 0.841-0.977 ), daily intake of calcium ( ≥600 mg, OR: 0.493-0.644, 95%CI: 0.389-0.786 ), vitamin D3 level ( ≥20 ng/mL, OR: 0.604-0.719, 95%CI: 0.523-0.853 ) and high-density lipoprotein cholesterol ( OR=0.658, 95%CI: 0.550-0.767 ) as factors affecting the development of PMOP.@*Conclusions @#The prevalence of PMOP in Dali Bai Autonomous Prefecture is similar to the nationwide level in China, and old age, smoking, alcohol consumption, a family history of osteoporosis and high blood lipid levels may increase the risk of PMOP.

Sequence analysis of VP7 gene of G9 group A rotavirus in Xiamen area / 中华传染病杂志

Objective:To understand the genetic variations of the coding gene of the main neutralizing antigen VP7 of G9 group A rotavirus in Xiamen area and the difference between VP7 gene in some domestic and broad areas. Methods:Four types G9 group A rotavirus strains were collected from feces of children with diarrhea in Xiamen Children′s Hospital. The time of collection was October 5, 2017, November 12, 2017, December 7, 2017 and January 15, 2018, respectively. The full-length sequence of type G9 group A rotavirus VP7 gene was obtained by reverse transcription polymerase chain reaction, and the homology, phylogenetic and amino acid sequence alignment were analyzed by using DNA Star, MEGA and other biological software. Results:Phylogenetic tree analysis showed that the local strain of Amoy CHINA/2018 in Xiamen area and the human/SC7/CHN/2013/G9 local strain in Chengdu City had the most closely relationship in the evolutionary tree clusters, and the homology was far from the Hu/JS2016 local strain in Jiangsu Province. The amino acid sequence analysis showed that compared with the reference strain WI61, the Xiamen local strains had variations in the amino acid primary structure, including D100N and Y144H, which were representative mutation sites in the Amoy CHINA/2018 phylogenetic tree cluster.Conclusion:The full-length genome sequence of the type G9 group A rotavirus VP7 shows that the strain is mutated in China.

Application of Health Education in Psychological Care of Patients Undergoing Hematopoietic Stem Cell Transplantation and Their Family Member / 中国医学伦理学

Hematopoietic stem cell transplantation has a good clinical effect on the treatment of hematologic malignancies, but during the treatment, it will bring relevant negative psychology to the patient' s psychology and body. This paper analyzed the psychological obstacles often emerging during the treatment of hematopoietic stem cell transplantation, as well as the family members' negative psychological emotion caused by the long-term psychological pressure and economic pressure, and further analyzed the reasons for the psychological problems in the patients and the corresponding nursing methods, and the causes of the psychological disorders of the patients' families and the corresponding nursing methods. In addition, health education was adopted for patients and their family members, and through the methods of doctor-patient communication, disease education, behavior training and so on, this paper found that after the implementation of health education for patients and their family members, the postoperative recovery rate of transplanted patients was obviously improved, and their psychological problems were also obviously alleviated and eliminated. It was proved that health education had a good therapeutic effect on the psychological problems of hematopoietic stem cell transplantation patients and their family member, and was worthy of promotion in clinical practice.

The Influence of Traditional Chinese Medicine Apprenticeship Teaching Mode on Doctor' s Humanistic Ethics Thought / 中国医学伦理学

In Traditional Chinese Medicine apprentice education mode, the heritages of medical skills, medical principles and medical knowledge are three important components. The important component of medical knowledge is the inheritance and development of medical humanistic ethics. With the progress of medicine, the increase of ac-ademic exchange between China and the West, the inheritance of Traditional Chinese Medicine medical knowledge has become an indispensable part, and has attracted the attention both at home and abroad. Traditional Chinese Medicine apprenticeship mode in the new period is based on the education in colleges and schools and shows its u-nique superiority in the inheritance of medical humanistic ethics thought through famous doctors' studio, apprentice-ship and other methods.

Investigation and Analysis of the Influencing Factors of Informed Consent of Subjects in Drug Clinical Trial / 中国医学伦理学

Taking a class A tertiary hospital in Shanghai as center, this paper understood the awareness of the subjects of drug clinical trials on their participation in the research and their own rights as subjects after the end of research (6～18 months) by questionnaire survey completed by telephone interview, analyzed the problems existing in the process of informed consent, compared with the foreign status, and summed up a variety of feasible ways of subject' s own right to be informed, to put forward feasible suggestions for the development and improvement of medical scientific research management and the ethical work in China.

Domestic and Foreign Application of Extensive Informed Consent in Future Research / 中国医学伦理学

Extensive informed consent is a special form of informed consent.In foreign countries,the applica-tion and implementation of extensive informed consent has enhanced the circulation rate of biological samples in fu-ture research and promoted the development of the clinical research of biological samples.But it also has caused some ethical issues because of weakening informed such as:obtaining the information about the subject not in time,the research risks unknown and quiting research not in time.At present,Europe and the United States have conducted a lot of research in the implementation conditions,informed content and framework,providing a strong support for the practice of extensive informed consent.The practice of extensive informed consent has become the development direction of the biological samples research in our country.The author compared the social environ-ment and theoretical research at home and abroad and thought that our country must practice and implement it on the basis of social recognition,the improvement of ethical review mechanism and legislative protection.

Exploring the application of case mix index in nursing unit for risk assessment / 中华医院管理杂志

Objective To explore the feasibility to apply case mix index ( CMI) in risk assessment of clinical nursing units. Methods Questionnaire was designed and used to evaluate risk ratings for 43 nursing units with wards, with the survey results subject to expert scoring. The units consisted of 16 in surgical system, 15 in internal medicine, and 7 in traditional Chinese medicine system. Statistical method was used to analyze the correlation of the expert scoring and CMI. Results The CMI of nursing units and expert scoring results had strong correlation (r=0. 69, P<0. 05). Two groups of data in surgical system and internal medicine system were highly correlated (r= 0. 716, P<0. 05; r= 0. 643, P<0. 05 respectively), while the two groups of data in traditional Chinese medicine system had no correlation (r=0. 572, P>0. 05). Conclusions CMI can be used as a reference for dynamic risk assessment of nursing units.

Exploring the application of case mix index in nursing unit for risk assessment / 中华医院管理杂志

Objective To explore the feasibility to apply case mix index ( CMI) in risk assessment of clinical nursing units. Methods Questionnaire was designed and used to evaluate risk ratings for 43 nursing units with wards, with the survey results subject to expert scoring. The units consisted of 16 in surgical system, 15 in internal medicine, and 7 in traditional Chinese medicine system. Statistical method was used to analyze the correlation of the expert scoring and CMI. Results The CMI of nursing units and expert scoring results had strong correlation (r=0. 69, P<0. 05). Two groups of data in surgical system and internal medicine system were highly correlated (r= 0. 716, P<0. 05; r= 0. 643, P<0. 05 respectively), while the two groups of data in traditional Chinese medicine system had no correlation (r=0. 572, P>0. 05). Conclusions CMI can be used as a reference for dynamic risk assessment of nursing units.

An Investigation of Broad Consent and the Health Data Sharing Privacy Protection in Medical Institutions / 世界科学技术-中医药现代化

With the rapid development of network technology,the data sharing and health research provides an efficient and convenient way for medical research and clinical guidance.In order to know patients' opinions on informed consent and data sharing,we investigated first-class hospitals in the coastal and inland areas with a total of 397 patients participating the questionnaire on clinical health and data sharing,reusing the remaining clinical blood samples in scientific researches,and the acceptance degree of broad consent investigation and related influencing factors.It was found that patients with strong consciousness of informed consent right tended to choose a simpler way of informed consent based on the analysis.Patients preferred social benefits than personal benefits with a strong spirit of dedication to the community.Medical institutions in China rarely applied broad consents and took relervant summative researhes,compared with the European and American countries' promotions at the national level.The research afforded the evidence,from most of patients' point of view to ethics committee in the review of such kind of studies to understand the public data sharing in privacy protection and broad consent of the individual opinion,in order to facilitate the rational development and promotion of health data sharing in China ethically.

Expression, purification and characterization of human inhibitory receptor TIGIT in E.coli / 上海交通大学学报（医学版）

Objective · To prepare recombinant human TIGIT protein in E.coli and characterize its ability in binding Fusobacterium nucleatum (Fn). Methods · The gene of immunomodulatory protein of human TIGIT was amplified and cloned into pGEX4T2, and recombinant plasmid was transformed into E.coli BL21 (DE3) for GST-TIGIT fusion proteins were purified by the GST affinity chromatography and the interaction between GST-TIGIT fusion protein and Fn was tested by a pulldown assay. Results · Recombinant GST-TIGIT fusion protein expressed successfully in E.coli and was purified to homogeneity by GST affinity column. This protein could specifically bind to Fn, but not Lactobacillus acidophilus. Conclusion · High purify and activity of human GST-TIGIT fusion protein can be achieved by the prokaryotic expression system, and the adhesion between this protein and Fn has been preliminarily explored, which provides basis for further characterize interaction between them.

Correlation between routine blood test results and antiviral effect in patients with refractory chronic hepatitis C treated with pegylated interferon-α / 临床肝胆病杂志

ObjectiveTo investigate the correlation between the changes in routine blood test results and antiviral effect in patients with refractory chronic hepatitis C receiving standard treatment. MethodsA total of 63 previously untreated patients with refractory chronic hepatitis C who visited Beijing YouAn Hospital, Capital Medical University, from September 2011 to December 2012 were enrolled. The patients were treated with pegylated interferon-α-2a 180 μg/week and ribavirin (RBV) for 48 weeks. HCV RNA measurement and routine blood tests were performed at baseline and weeks 4, 12, and 24 of treatment to analyze the correlation between routine blood test results and antiviral effect. According to the status of sustained virologic response (SVR), the patients were divided into SVR group and nSVR group. The t-test was used for comparison of continuous data between groups, the chi-square test was used for comparison of categorical data between groups, and a simple linear correlation analysis was performed. ResultsOf the 63 patients, three were lost to follow-up, and the other 60 patients completed the antiviral therapy and 24-week follow-up; among the 60 patients, 46 achieved SVR, resulting in an SVR rate of 76.7%. Compared with the nSVR group, the SVR group showed lower absolute lymphocyte count (LYPH), white blood cell count (WBC), and absolute neutrophil count (NUET), and the three indicators were significantly different between the two groups at 12 weeks (t=3.398, 2.766, and 2.037, all P＜0.05); WBC and NUET still showed significant differences between the two groups at 24 weeks (t=2.559 and 2.151, both P＜0.05). In addition, at week 4 of treatment, the SVR group showed significantly greater reductions in these three indicators from baseline compared with the nSVR group, LYPH showed significant different between the two groups(t=226,P=003). At weeks 4 and 12 of treatment, LYPH, WBC, and NEUT were positively correlated with the reduction in HCV RNA (r=0.36, 045, 0.37, 0.47, 0.61, and 0.33, all P＜0.05). ConclusionThe reductions in LYPH, WBC, and NEUT can be used as predictive indicators for antiviral effect in patients with refractory chronic hepatitis C.

The impact of mindfulness on nurses' professional quality of life / 中国实用护理杂志

Objective To provide a scientific basis for nursing managers to promote the professional quality of life of nurses.Methods Totally 373 nurses from three general hospitals in Jinan by convenience sampling technique were recruited and assessed with the Professional Quality of Life Scale Version 5 (ProQOL-V) and the Five Facet Mindfulness Questionnaire.The relationship between professional quality of life and mindfulness was analyzed.Results The average score of compassion satisfaction was (29.71±6.61) points,the average score of compassion fatigue was (52.82±8.04) points,which were in the middle level of them.Compassion satisfaction was correlated with mindfulness,observation,description,non-reactiveness and non-judgment (P ＜ 0.05).Compassion fatigue was correlated with mindfulness,observation,awareness of the action,non-reactiveness and non-judgment (P ＜ 0.05).Multiple regression analysis showed that the three dimensions (observation,non-reactiveness and non-judgment) of mindfulness could predict 15％ variance of compassion satisfaction and the three dimensions (observation,awareness of the action and non-judgment) of mindfulness could predict 34.1％ variance of compassion fatigue after controlling demographic variables.Conclusions Mindfulness can effectively predict nurses' professional quality of life.Nursing managers should take some mindfulness training in order to improve their professional quality of life.

Effect of azelastine hydrochloride nasal spray combined with desloratadine to inflammatory factors, cell function and IgE of patients with allergic rhinitis / 中国生化药物杂志

Objective To explore the effect of azelastine hydrochloride nasal spray combined with desloratadine to inflammatory factors, cell function and IgE of patients with allergic rhinitis.Methods 92 cases of allergic rhinitis patients treated in the first affiliated hospital of wenzhou medical college hospital from June 2014 to December 2015 were divided into experimental group(n=46) and control group(n=46) according to the random number table method.The control group was given oral loratadine tablets, one piece per time, one time per day, while the experimental group was given azelastine hydrochloride nasal spray on the basis of the control group,each nostril one spray, one time in the morning and night.The clinical efficacy of two groups of patients would be observed after 4 weeks,ELISA would be used to detect serum levels of IFN-γ, IL-4, IL-8 and IgE level, and IFN-γ/IL-4 was the value of Thl/Th2,flow cytometry instrument was used to the determination of T cell subgroup CD4 +,CD8 + cells.Results 4 weeks after treatment,stuffy nose, nasal itching, runny nose, sneezing and nasal cavity change points are lower than before the treatment in both the two groups.Experimental group obviously lower than the control group, the difference was statistically significant ( P <0.05 ).The total effective rate of treatment group is higher than the control group,the difference was statistically significant(χ2 =4.389,P=0.036).The serum level of IFN-γis higher than before treatment in both the two groups.IL-4, IL-8 inflammatory factor levels were lower than before treatment,the experimental group was better than control group,the difference was statistically significant(P<0.05).CD4 +,CD8 +of T cells and Thl/Th2 values are higher than before the treatment in both the two groups,the experimental group was higher than control group, the difference was statistically significant ( P<0.05 ).Serum IgE levels were lower than before the treatment in both the two groups,the experimental group was lower than control group,the difference was statistically significant (P<0.05).Conclusion The therapy of azelastine hydrochloride nasal spray combined with desloratadine can improve the clinical effect of the treatment of allergic rhinitis,reduce inflammation,strengthen the body's immune function, improve thelevel of serum IgE.

Ethical Considerations on the Reuse of Clinical Laboratory Blood Samples in Research / 中国医学伦理学

By referring to the domestic and foreign relevant regulatory guidelines, this paper analyzed and sum-marized the ethical point in the design phase in the perspective of relevant regulations of clinical waste sample man-agement and biological sample management. It also analyzed the focus problems including the difference in sample library and clinical laboratory remaining sample as well as the ownership of the sample, to provide theoretical basis for ethics committee to review this kind of protocols.

The effect of palliative care in the treatment of pain and life quality in later period tumor patients / 中国基层医药

Objective To evaluate the effect of palliative care in the treatment of pain and life quality in later period tumor patients.Methods 103 patients with advanced tumors in our hospital were selected and divided into group A(51 patients) and group B(52 patients) based on the methods of treatment.The patients in group A were given conventional treatment,and the patients in group B were given palliative care program on the basis of the treat-ment in group A.The effects of the groups A and B were observed and compared.Results The pain levels of group A and B before treatment had no statistically significant difference (P>0.05).The pain level score of group B after treatment was (26.41 ±3.55)points,which was lower than (32.56 ±7.12)points in group A,and the difference was statistically significant (t=6.430,P0.05).After treatment,the life quality score of group B was (66.85 ±6.75)points,which was higher than (53.39 ±6.74)points in group A,and the difference was statistically significant (P<0.05).Conclusion It is effective for palliative care to treat the patients with advanced tumors on their pain management and quality of life, which is worthy of clinical application.