[Objective] To explore the anti-inflammatory effects of emodin and its therapeutic effect on acute lung injury. [Methods] By means of analyzing the relevant literatures in PUBMED,CNKI,CBM,Wanfang and Vip Da-tabase from 1998 to 2012,summarized the anti-inflammatory effects and mecha-nisms of emodin, as wel as its therapeutic effect on acute lung injury. [Results] A variety of studies have confirmed the anti-inflammatory effects of emodin, whose mechanism is related to emodin inhibiting the activation of NF-kappa B,modulaing various inflammatory factors, etc. In addition, the effect of emodin in the treatment of acute lung injury has been confirmed on celland animal levels. [Conclusion] Emodin has good prospect of clinical application.

Objective] To research professor Cai’s experience in treating stable chronic obstructive pulmonary disease(COPD). [Method] The paper expounds Professor Cai’s experience in treating stable chronic obstructive pulmonary disease by analyzing the etiology, pathology, summarizing the clinical thoughts and citing the typical case. [Result] Professor Cai emphasized therapies of strengthening body resistance,replenishing Qi,treating zang and fu together,activating blood,dredging collaterals, treating disease with the theory of Chinese medicine and modern medicine as well as applying the theory of preventive treatment of disease on preventing the exacerbation of COPD. Better clinical effects were acquired. [Conclusion] Professor Cai Wanru always grabs for the treatment of qi deficiency and phlegm, blood stasis of the disease.She is good at prescribing formula. Therefore the treating method has clinical value.

Objective] To summarize the diagnosis and treatment of Professor Cai Wanru, famous Chinese medicine doctor of the state, the tutor of doctoral student in treating bronchial asthma. [Method] The author studies from the teacher, col ecting medical records, analyzing and learning the dialectical thinking and prescriptions of Professor Cai during treating bronchial asthma. [Results] According to the different stages of bronchial asthma, Professor Cai adopts the combination of differentiation and disease differentiation, uses Chinese medicine to treat bronchial asthma. We should clean lung and phlegm, smoothen breathing during exacerbation of asthma, invigorate the spleen and tonify the lung qi during remission of asthma, at the same time advocate treating winter disease in summer during consolidating period. In addition, clearing lung and regulating Qi should be used throughout al the course of disease. Professor Cai is good at using drug pairs and Chinese medicine flexibly, simply, effectively. [Conclusion] Professor Cai Wanru has been engaged in clinical respiratory department of internal medicine for a long time, having rich experience and unique insights on bronchial asthma, chronic cough, chronic obstructive pulmonary disease and other common respiratory system disease, worth learning.

Objective:To observe the effect of diammonium glycyrrhizinate injection on bronchus,lung tissue and amount of eosinophils(EOS)in rats with asthma and to discuss the mechanism of diammonium glycyrrhizinate intervention on airway inflammation in asthma.Methods:To divide 60 male SD rats into 6 groups as following:normal control group,model group,dexameth group,high dose of diammonium glycyrrhizinate group,middle dose of diammonium glycyrrhizinate group and low dose of diammonium glycyrrhizinate group(n=10).After setting up the model of rats with asthma,we detect the EOS in both rats'blood serum and bronchoalveolar lavage and observe the pathological change in bronchus and lung tissue in rats of each group.Results:Not only the amount of EOS of rats in model group is bigger than that in normal control group(P

Professor Cai Wanru believes that in the stable phase of chronic obstructive pulmonary disease, "phlegm" and "stasis" are intertwined, with "phlegm" as the main component. Disease is manifested mostly in the lungs, spleen and kidney, and along with the duration of the disease, the patients are prone to "sputum", "stasis" and other pathological products, so that acute aggravating symptoms are often induced due to the transformation from "phlegm" to "stasis". The clinical manifestations are mainly the lack of righteousness, and various symptoms due to phlegm stagnation and blood stasis. Therefore, Professor Cai believes that the thought of "preventive treatment of disease" should be throughout the treatment of the disease. The thought is based on the principle of the relationships between the five internal organs. According to the characteristics of disease transmission, combined with the syndrome differentiation of physical constitution, the importance of strengthening the body resistance and nourishing the vigour was emphasized. In terms of the methods of treatment, methods such as nourishing the lungs and tonifying the spleen, warming the kidney and tonifying qi are often applied, so the prescription is flexible and the compatibility is rigorous. In terms of the control of symptoms and prevention of acute exacerbations, it has a significant effect. Therefore, the thought of "preventive treatment of disease" proposed by Professor Cai Wanru has a practical value in the clinical treatment of chronic obstructive pulmonary disease, which is worthy of promotion.

Objective:To assess the accuracy of lung ultrasound(LUS) to predict pneumonia in pediatric patients using meta-analysis.Methods:The PubMed, the Cochrane Library, EMbase databases from January 2015 to March 2020 were searched.The retrieved outcome data to evaluate the efficacy of LUS for the diagnosis of pneumonia in patients under 18 years of age were included.Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies.Meta-analysis was then conducted using MetaDisc 1.4, RevMan 5.3 and Stata 15.0 softwares.Results:Twelve diagnostic studies were included, which involved 2 484 patients.The results of meta-analysis showed that compared with the gold standard, the sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio of LUS were 0.90(95% CI 0.88-0.91), 0.88(95% CI 0.85-0.90), 8.64(95% CI 3.79-19.72), 0.12(95% CI 0.06-0.26) and 77.58(95% CI 28.39-211.99), respectively.The area under the summary receiver operating characteri stic curve was 0.96.Subgroup analysis showed that there was no difference in LUS′s diagnostic accuracy for pneumonia with different department, different diagnostic gold standard, and different level of sonographer training. Conclusion:Current evidence shows that LUS has a high accuracy in the diagnosis of pneumonia in children.

Objective: To detect the arthropathies on no bleeding history joints in pre-school hemophilia A children in order to provide evidence for further prevention and control of joint disease in children with hemophilia A. Methods: This study was a cross-sectional study based on China Hemophilia Individualized prophylaxis study (CHIPS). The basic data of outpatients with hemophilia in Beijing Children's Hospital and Chengdu Women's and Children's Central Hospital between August 2016 and June 2017 were collected and a three-month follow-up was conducted. The target joints (six joints of bilateral elbows, knees and ankles) of thirty-four children aged 1-7 years old with severe hemophilia A were examined by ultrasound, X-ray and joint function examination (4-7 years old, hemophilia joint health score (HJHS)). To find out whether there are arthropathies in patient's joints with no bleeding history and analyze the relevant factors by chi-square test, rank sum test and other statistical methods. Results: There were 32 analyzable cases with 112 no-bleeding history target joints, 42.9% (48/112) were elbow joints. Arthropathies were revealed in 34.8% (39/112) of them by joint structural and functional examination and 46.2% (18/39) were ankles (χ²=8.379, P=0.015) . Ultrasound showed abnormalities in 18.3% (20/109) joints, X-ray showed abnormalities in 3.8% (3/79) joints and HJHS showed abnormalities in 25.3% (20/79) joints. There was no correlation between ultrasound and HJHS (r=0.015, P=0.895), no correlation was found between X-ray and HJHS (r=-0.101, P=0.390) either, which suggested that joint structural and functional examination could not replace each other. The related risk factors of arthropathies in this group were >4.91 years old (OR=3.917, 95%CI:1.610-9.528) and combining with target joint (OR=3.530, 95%CI:1.316-9.465). Conclusions Detecting the joint structure and function on no bleeding history joints in pre-school hemophilia A children could reveal the arthropathies and majority of them were ankle arthropathies. Joint structural and functional examinations could not replace each other. For patients more than 5 years old and those with target joints, the joints with no complaint of bleeding should be examined regularly to reveal the arthropathies in time.

Objective:To understand the relationship between joint bleeding and joint disease in hemophilia children, and to provide a theoretical basis for clinical treatment and prognosis.Methods:The patients with severe hemophilia A between 1 and 7 years old and with relevant nodal bleeding records were selected.All the patients admitted in Beijing Children′s Hospital, Capital Medical University, and Chengdu New Century Women′s and Children′s Hospital since June 2016 to January 2017.All the joint bleeding of each child was taken as the study joint, and the joint bleeding was collected during the last 3 months.The joints were assessed by using ultrasound, X-ray, magnetic resonance imaging(MRI) and Hemophilia Joint Health Score (HJHS) scoring systems.The correlation analysis was conducted between the joint bleeding, ultrasound, X-ray, MRI and HJHS scores.The correlation analysis was conducted for baseline ultrasound, X-ray, MRI and HJHS scores.Results:(1) There were 18 patients enrolled.The mean age was (5.6±1.8) years old.There were 30 joints bleeding in the observation period in total, with the annul median joint bleeding times of 4 (4-16 times), and the annul median target joint bleeding times of 8 (4-16 times). (2) Joint bleeding times of was correlated with ultrasound and X-ray evaluation ( r=0.390, P=0.033; r=0.517, P=0.008), and not correlated with HJHS or MRI(all P>0.05). (3) There was significantly positive correlation among ultrasound, X-ray, HJHS and MRI [ r=0.815(ultrasound vs.X-ray), r=0.510(ultrasound vs.HJHS), r=0.812(ultrasound vs.MRI), r=0.666(X-ray vs.HJHS), r=0.911(X-ray vs.MRI), r=0.781(HJHS vs.MRI), all P<0.01]. (4) There was no correlation between times and assessment for joints whose ultrasound and /or MRI in joints with abnormal ultrasound and /or MRI evaluation( P>0.05). Conclusions:The results of joint bleeding and joint evaluation are inconsistent.Joint bleeding can not truly reflect the situation of joint diseases.The assessment of hemophilia should include comprehensive evaluation of joint structure, function, activity ability and other aspects to guide the treatment of haemophi-lia children.