Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

ObjectiveTo evaluate the efficacy and safety of An'erning granules in the treatment of community-acquired pneumonia in children. MethodA randomized， double-blind， single-simulation， placebo-controlled trial was designed in this study. The children were randomly assigned into an observation group （An'erning granules combined with ceftriaxone sodium） and a control group （An'erning granules placebo combined with ceftriaxone sodium） according to the ratio of 2∶1. The disease cure rate was taken as the main indicator of efficacy， and the safety of An'erning granules was observed. ResultA total of 206 children （137 in the observation group and 69 in the control group） were included in this study. Before treatment， the age， sex， body height， body weight， diagnosis time of pneumonia， and symptom and sign scores had no significant differences between the two groups. After 8 days of continuous medication， the observation group［70.80%（97/137）］ had higher cure rate than the control group［56.52%（39/69）］（χ²=4.17，P<0.05） and total effective rate of chest X-ray ［97.98%（97/99）］ than the control group［86.27%（44/51）］ （χ²=12.98，P<0.01）. The observation group was superior to the control group in the alleviation of TCM syndrome under the condition of 0-3 g dose stratification on day 3 of medication （P<0.01）. The recovery time， time to complete fever abatement， time to fever abatement and expectoration alleviation， rate of conversion to severe case， and reduction in the frequency of antibiotic use showed no significant differences between the two groups. In terms of safety， 13 and 7 adverse events occurred in the observation group and control group， respectively， which were relieved or disappeared after drug withdrawal or symptomatic treatment and showed no significant difference between the two groups. ConclusionIntravenous drip of ceftriaxone sodium combined with An'erning granules is effective in the treatment of community-acquired pneumonia in children. It can accelerate the absorption of pulmonary inflammation， alleviate the clinical symptoms in a short time for young children or the children with mild symptoms， and is safe in clinical application.

Objective:To investigate the association between systemic inflammation response index (SIRI) and early neurological deterioration (END) in patients with basal ganglia hemorrhage (BGH), and then set up a prediction Nomogram model for END.Methods:The retrospective cohort study was conducted. A total of 146 patients with BGH from January 2016 to December 2018 were chosen in the Affiliated Jiangyin Hospital of Southeast University Medical College. The patients were divided into the END group ( n=34) and non-END group ( n=112), according to whether END occurred or not. The normally distributed data were presented as the mean±standard deviation ( Mean± SD), and the groups were compared using the t test. The non-normally distributed data were expressed as M ( P25, P75), and this data was analysed via the Kruskal-Wallis test. Categorical variables were described as numbers of patients (%) and compared using chi-square analysis or Fisher exact test, as appropriate. Univariate analysis and multivariate logistic regression analysis were used to identify the risk factors of END occurrence, and the relationship with SIRI. Then, each factor was scored by Nomogram method to construct the prediction model. Receiver operating characteristic curve (ROC) was drawn to assess the predictive value of SIRI and Nomogram model in the occurrence of END. Results:Univariate analysis showed that the occurrence of END was associated with hematoma volume, presence of intraventricular hemorrhage, blood glucose, lymphocyte count and SIRI ( P<0.05). Multivariate logistic regression analysis showed that hematoma volume ( P<0.001), presence of intraventricular hemorrhage ( P=0.012) and SIRI ( P=0.023) are independent risk factors for END occurrence. ROC curve analysis showed that SIRI has certain predictive value for END occurrence, and the optimal cut-off value was SIRI=5.40×10 9/L. Then these risk factors were incorporated into the Nomogram. Statistically analysis showed the model had a good predictive value, and the model combining the SIRI and other prognostic factors (AUC=0.869, 95% CI: 0.804-0.935, P<0.001) showed more favorable discriminative ability than the model without the SIRI (AUC=0.811, 95% CI: 0.734-0.889, P<0.001) and the model using the SIRI only (AUC=0.716, 95% CI: 0.622-0.810, P<0.001). Conclusion:SIRI is closely correlated with the occurrence of END in patients with BGH, and the nomogram model combining the SIRI has a more accurately predictive value, which improved the early identification and screening of END, and patient outcomes.

Objective:To compare the efficacy of HES 130/0.4 and acetate Ringer′s solution (A-HES) and HES 130/0.4 and normal saline (NS-HES) for volume therapy in the patients undergoing non-cardiac surgery with general anesthesia.Methods:Two hundred and fifty American Society of Anesthesiologist physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 18-32 kg/m 2, undergoing noncardiac surgery with general anesthesia, were divided into group A-HES and group NS-HES using the stratified block randomization technique.A-HES and NS-HES 15 ml/kg were intravenously infused over 1 h immediately after induction of anesthesia in A-HES and NS-HES groups, respectively.Mean arterial pressure (MAP), heart rate (HR) and central venous pressure (CVP) were recorded before and after infusion, and the maximum changing rate of MAP and HR and the maximum change in CVP were calculated.The pH value, BE and HCO 3- were recorded before infusion and at 15 min after the end of infusion, and Hb, Hct, electrolytes, blood glucose, blood biochemical parameters and parameters of coagulation function were measured.The occurrence of abnormal blood biochemical parameters, blood glucose, and parameters of coagulation function, intraoperative requirement for vasoactive drugs, occurrence of HES-related adverse events, and intraoperative fluid intake and output were recorded. Results:A total of 251 cases were actually enrolled in this study, with 125 cases in group A-HES, and 126 cases in group NS-HES.Compared with group NS-HES, no significant change was found in the maximum changing rate of MAP and HR and the maximum change in CVP ( P>0.05) in group A-HES, and non-inferiority analysis showed that group A-HES was not inferior to group NS-HES.Compared with group NS-HES, the concentrations of BE and HCO 3-, K + , Ca 2+ and Mg 2+ were significantly increased, the concentrations of Na + and Cl - were decreased, the PT was shortened, the incidence of abnormal PT was decreased at 15 min after the end of infusion ( P< 0.05), and no significant change was found in the other parameters mentioned above in group A-HES ( P>0.05). Conclusion:The volume expanding effect of A-HES and its effect on liver and kidney function are not significantly different from those of NS-HES, however, A-HES has certain advantages in maintaining acid-base balance, electrolyte stability and coagulation function.

Objective To explore the correlation between the posterior vertebral muscle group aging degeneration and body mass index (BMI) in normal middle-aged and elderly women.Methods One hundred and fifteen women(48-75 years old) were divided into the middle-aged group (＜60 years old) and elderly group (≥60 years old).The muscle area of posterior vertebral muscle group and fat area at lumbar levels L3 were measured by quantitative computed tomography (QCT).The muscle fat infiltration (MFI),e.g.fat area/(muscle area + fat area),was calculated.The differences between the two groups were compared by using independent-samples t test.The correlation and linear regression analysis were used for analyzing the correlations between the muscle area,fat area and MFI with age and BMI.Results The BMI had no statistical difference between the two groups (P＞0.05),while the muscle area of posterior vertebral muscle group,fat area and MFI had statistical difference (t=2.182,-1.997,-2.604,P=0.031,0.048,0.010);the correlation and linear regression analysis showed that controlling the body height,body mass factor and age were positively correlated with the fat area of posterior vertebral muscle group and MFI(r=0.275,0.320,t=2.915,3.445,P=0.004,0.001),while had no obvious correlation with the muscle area(r=-1.109,P =0.270);controlling age factor and BMI were positively correlated with the fat area of posterior vertebral muscle group and MFI(r=0.361,0.307,t=3.945,3.277,P≤0.001),while had no obvious correlation with the muscle area(t=1.653,P=0.101).Conclusion In middle-aged and elderly women,the fat content of posterior vertebral muscle group is increased with the age increase.In evaluating the degeneration,especially greater body mass,the fat content of muscles and their proportion have more significance than the muscle area.

Depression, a seriously harmful disease to peoples ’ physical and mental health , is prevailing world-wide.But the etiology and pathological mechanism is still not fully uncovered .With the development of social economy and the pace of life speeding up , increasing pressure and vulnerable emotion cause depression incidence increased rapidly .For the further research on depression , study of depression mechanism and antidepressant drugs highly depends on effective ani -mal models .The degree of similarity of animal models to human disease status and the accuracy and reliability of evaluation methods of animal models directly influence the value of the resuts of experiments .In this article we introduce the common-ly used animal models of depression , the evaluation indicators at organism , organ, and molecular levels , and to provide theoretical references for the further studies on depression .

Objective To observe the different characteristics of spontaneous activitiy after simulated weightlessness 21 days in rats , aimed to provide a evaluation method for space weightlessness induced function change in human beings and to provide a reference for researches on the astronauts protective measures .Methods 30 Wistar male rats were randomly divided into three groups , the control group , the sham tail-suspended hindlimb unloading group ( the sham group ) , the tail-suspended hindlimb unloading group ( the suspending group ) , ten animals in each group .All animals were placed in the simulated space flight environmental equipment which has a real -time monitor system for 21 days.During the 21 days, the intake of water , food and the body weight were measured every week .Meanwhile, five independent activity data were collect every day , for example, morning(8:00am~12:00am), afternoon(2:00pm~6:00pm), daytime(8:00am~8:00pm),night(8:00pm~8:00am),and whole day (8:00am ~8:00am).Results The spontaneous activity of normal rats in the control group between morning and afternoon had no significant difference , but it is significantly between night and daytime .The movement time and distance in night are 2 -3 times than that of the daytime.After 10 days of tail suspending , the circadian rhythm was disordered , and the spontaneous activity in day and night become more similar in rats of the suspending group .Because of the individual difference , the spontaneous activity is not stable at the first 10 days in rats of the sham group , but after 10 days, it become close to the control group .Conclusion Rat is nocturnal animal and sleeps in the daytime , the spontaneous activity in night is 2 -3 times as compared with the daytime.The sham tail-suspended hindlimb unloading 21 days can not influence the circadian rhythm in rats .Tail suspending 21 days will caused to the disappearance in the circadian rhythm in rats .

Objective To investigate error-related negativity characteristics of patients with internalizing mental disorders and its diagnostic value.Methods Fifty-five patients met with DSM-Ⅳ anxiety or depression criteria were sampled from outpatients and inpatients,and 20 normal adults were selected as control group.With Eriksen and Simon tasks as evoked stimuli,error-related negativities of each participant were acquired using Canada Stellate-64 channel EEG/ERP Instrument and BESA5.2 software,and the data of general information,clinical symptoms,reaction time,and error rate were collected.Results (1) Correct reaction time ((377.5±98.8) ms)and errors reaction time ((337.3±96.6)ms) of patient group were significantly longer than those of control group ((288.5±105.9)ms and (281.9±94.3)ms) on the Eriksen task and Simon task,and there were no significantly group differences on other indicators (P＞0.05).(2) ERN amplitudes at 6 sities (Fz =(4.97±5.74) μV,F3 =(5.50±4.59) μV,F4 =(6.26±6.79) μV,Cz =(4.74±5.51) μV,C3 =(5.44±4.8) μV,C4 =(5.50± 5.28) μV) of patients group were significantly greater than those of control group ((1.17± 1.47)μV,(2.22±3.95) μV,(3.40±2.55)μV,(2.28± 1.41) μV,(3.05±2.47) μV,(3.16±2.51) μV) on the Eriksen task.ERN amplitudes at Fz((5.43±6.61) μV) and F4((6.00±5.50)μV) of patient group were significantly were greater than those of control group ((2.05 ±2.34) μV,(3.09±2.86)μV) on the Simon task,and there were no significantly group differences on the ERN amplitudes at other sites (P＞0.05).(3) ERN latencies ((87.6±34.4) ms and (84.9±34.8) ms) of patient group at Fz and F4 were significantly longer than control group ((54.0±46.5) ms and (36.3±42.4)ms) on the Simon task,and there were no significantly group differences on the ERN latencies at other sites (P＞0.05).Conclusion The increased error related potentials suggest that patients with internalizing mental disorders has an internal error monitoring defects,and ERN might be a useful endophenotype for internalizing mental disorders.

Objective To evaluate the efficacy and safety of oxycodone hydrochloride injection for postoperative analgesia in patients undergoing the operation under general anesthesia in a prospective,randomized,blind,multicenter,positive-controlled,clinical trial.Methods Two hundred and forty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 40-95 kg,scheduled for elective abdominal operation or orthopedic surgeries under general anesthesia,were randomly divided into 2 groups (n =120 each):morphine sulfate injection group (group M) and oxycodone hydrochloride injection group (group O).Morphine or oxycodone 1 mg was injected intravenously when the patients complained of pain after tracheal extubation or removal of the laryngeal mask,and administration was repeated if necessary until VAS≤40 mm.Then patient-controlled intravenous analgesia (PCIA) (100 ml,0.5 mg/ml) with morphine or oxycodone was used for postoperative analgesia (lasting for 48 h).The PCIA pump was set up with a 1 ml bolus dose,a 5 min lockout interval and background infusion at a rate of 0.5 mg/h.Pain at rest and during movement was assessed using VAS score at 3,24 and 48 h after administration,and non-inferiority test was performed.Total morphine or oxycodone consumption,requirement for rescue analgesic,the number of unsuccessfully delivered dose,the number of attempts,and the level of patient' s satisfaction were recorded within 48 h after operation.The adverse events were recorded and laboratory examinations (blood and urine routine test,blood biochemical examination) were performed within 72 h after administration.Results There was no significant difference in the VAS scores at rest and during movement at different time points,requirement for rescue analgesic,the number of unsuccessfully delivered doses and attempts,level of patient' s satisfaction,total morphine or oxycodone consumption,and adverse events between the two groups (P ＞ 0.05).No serious adverse event occurred in the two groups.The most common adverse event was nausea,followed by vomiting.There was no significant difference in the incidences and degree of nausea and vomiting between the two groups (P ＞ 0.05).The incidences of nausea and vomiting in patients underwent orthopedic surgeries were significantly lower in group O than in group M (P ＜ 0.05).The other adverse events were fewer and abnormal laboratory examinations were rare in the two groups.95％ confidence interval of the difference between the mean VAS scores at rest and during movement at each time point was within 15 mm (boundary values of non-inferiority testing) in the two groups.Conclusion PCIA with oxycodone hydrochloride injection is safe and effective in reducing pain after moderate or major operation,and the analgesic efficacy is similar to that of morphine sulfate injection,however,the development of nausea and vomiting is reduced when PCIA with oxycodone hydrochloride injection is used for orthopedic surgeries as compared with that when morphine sulfate injection is used and the ratio between the analgesic efficacy of the two drugs is close to 1∶1.

Objective To compare the phaimacodynamics and circulatory function of domestic and imported rocuronium. Methods This is a five center study of rocuronium. Two hundred and ten ASA Ⅰ or Ⅱ patients aged 18-65 yr undergoing elective surgery under general anesthesia were randomly divided into 2 groups (n = 105 each): domestic rocuronium group (group Ⅰ ) and imported rocuronium group (group Ⅱ ) . Anesthesia was induced and maintained with TCI of propofol (target plasma concentration = 3 mg/L) and remifentanil (target effect-site concentration = 2-4 μg/L) . Tracheal intubation was facilitated with intravenous rocuronium 0.6 mg/kg. The N-M function was assessed by accelerography (TOF-Watch(R) SX, Organon, Netherlands) using TOF stimulation of ulnar nerve. Onset time, clinical duration, 75% recovery time,recovery indexes, the extent of maximal NM blockade and intubation conditions (ease of laryngoscopy, position of vocal cords and airway reaction) were monitored and recorded. BP and HR were also recorded. Results There were no significant differences in the onset time, clinical duration, recovery indexes, the extent of maximal N-M blockade, the intubation conditions, BP, HR and adverse reactions between groups Ⅰ and Ⅱ ( P ＞ 0.05) . The 75% recovery time was significantly longer in group Ⅱ than in group Ⅰ (P ＜ 0.05＝. Conclusion The pharmacodynamics of domestic and imported rocuronium is comparable. The two drugs have no adverse effect on the circulatory function.