Objective:To investigate the relationship of the immune response and immune imbalance mediated by Th17 cells and Treg cells with pulmonary function in chronic obstructive pulmonary disease ( COPD) patients. Methods:90 COPD patients and 45 healthy volunteers with matched age and sex were selected. The COPD patients were divided into 2 groups according to the patient's condition. 45 healthy volunteers were collected as the control group. The lung function, Th17 cells, Treg cells and serum levels of in-flammatory cytokines were detected and compared. Results:In COPD patients, the FEV1%, FVC%, FEV1/FVC, Th17,Th17/Treg and inflammatory cytokines had increased in an order of moderate COPD, severe COPD and very severe COPD (P<0. 05). Treg had in-creased in an order of very severe COPD, severe COPD and moderate COPD ( P<0. 05 ) . FEV1%, FVC% and FEV1/FVC were negatively correlated with Th17 and Th17/Treg (P<0. 05). FEV1%, FVC% and FEV1/FVC were positively correlated with Treg (P<0. 05). Conclusion:Th17/Treg in peripheral blood of COPD patients is significantly correlated with the decrease of pulmonary func-tion.

Objective To observe the clinical features of diabetes combined with invasive pulmonary aspergillosis(IPA) and analyze its risk factors.Methods 38 diabetes patients combined with IPA (DM +IPA group) and 40 simple diabetes patients (DM group) were collected.The clinical data and biochemical index were compared between two groups.The risk factors of DM combined with IPA were analyzed.Results (1) In diabetes patients with IPA,the major clinical manifestations were cough,expectoration 42.11％ and fever 42.11％.The chest CTs often showed air crescent sign 39.47 ％ and halo sign(34.21％,13/38).The overall cure rate of antifungal therapy was 57.89％ and the mortality rate was 28.95％.(2) DM course[(13.37±2.14) vs (11.42±2.25) year],FPG[(17.84±3.15) vs (7.52±1.84) mmol/L],2 hPG[(22.90±4.63) vs (9.71±2.75) mmol/L],HbA1c[(9.03±2.65)％ vs (7.30±2.22)％],ESR[(94.62±31.49) vs (16.57±4.16) mm/h],C-RP[(55.42±30.19) vs (1.67±0.22)mg/L],PCT[(1.20±1.10) vs (0.07±0.05) ng/ml] and D-dimer[(475.81± 183.62) vs (320.34±105.11) μg/ml] were higher in DM+ IPA group than those in DM group(P＜0.05 or P＜0.01).(3)Logistic regression analysis showed that age,DM course,FPG and HbA1c were independent risk factors for DM with IPA(P＜0.05).Conclusion DM combined with IPA is a serious disorder with low cure rate and high mortality.The major clinical symptoms are cough,expectoration and fever with crescent signs and halo sign in CT images.Age,long DM course and poor blood sugar control maybe risk factors for DM patients combined with IPA.

Objective:To explore the compatibility and medication law of Cinnamomi Ramulus-Alismatis Rhizoma medicinal pair in ancient and modern prescriptions.Methods:Ancient prescriptions and Chinese patent medicines containing Cinnamomi Ramulus-Alismatis Rhizoma medicinal pair were retrieved from the database of ancient classic famous prescriptions 1.0 and the database of listed Chinese patent medicines 1.0 developed by the Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences. Excel 2019 was used to establish a database. The ancient and modern medical record cloud platform V2.3.5 and SPSS Modeler 18.0 software were used to perform frequency statistics, association rule analysis, clustering analysis, etc. on the data.Results:Totally 79 ancient articles with Cinnamomi Ramulus-Alismatis Rhizoma medicinal pair were obtained, including 76 ancient prescriptions, involving 250 kinds of Chinese materia medica; 25 kinds of Chinese patent medicine were obtained, involving 186 kinds of Chinese materia medica. The drug properties of ancient prescriptions and modern TCM patent medicines were both mainly warm, cold and neutral. The main tastes of ancient prescriptions and modern Chinese patent medicines were pungent, sweet and bitter. And the drugs mainly belong to spleen, lung, liver and kidney meridians. Correlation analysis suggested the same high-frequency association compatibility of ancient and modern prescriptions, Poria-Cinnamomi Ramulus-Alismatis Rhizoma, Atractylodis Rhizoma-Cinnamomi Ramulus-Alismatis Rhizoma, Atractylodis Macrocephalae Rhizoma-Cinnamomi Ramulus-Alismatis Rhizoma. Both clinical symptoms and diseases associated with medicinal compatibility of ancient prescriptions were intestinal flora, edema and vomiting. The syndrome types included bladder impoundment, dampness trapped in the guardian surface, internal retention of phlegm and morbid fluid. The clinical symptoms associated with medicinal compatibility of modern TCM patent medicine were limb joints pain and edema. The diseases included rheumatic arthritis (RA) and kidney disease. The syndrome types included wind-cold-dampness RA, stagnation of collaterals and kidney yang deficiency. High frequency drug clustering yielded 4 clustered squares.Conclusion:The core indications treated by Cinnamomi Ramulus-Alismatis Rhizoma are exogenous diseases with dampness caused by syndrome types including internal storage of water-dampness, cold-dampness obstruction and so on, which can provide reference for further in-depth research and guidance on clinical medication.

Cinnamomi Ramulus and Alismatis Rhizoma are commonly used in the treatment of external-contraction diseases. Cinnamomi Ramulus is pungent， sweet， and warm， with the effects of ventilating lung and dispersing cold， warming Yang and transforming Qi， and promoting water and liquid flow from Taiyang meridian to remove dampness. Alismatis Rhizoma is sweet and cold， with the effects of draining dampness and promoting urination， regulating the waterway， removing water retention in lung， and promoting urination to remove dampness and heat. Herbal pairs are extracted from the accumulated experience of medical practitioners over the ages in the use of medicines and have been proved by clinical application to be composed of simple and effective combinations for specific diseases. The herb pair Cinnamomi Ramulus-Alismatis Rhizoma is an important part in ancient classic formulas such as Wulingsan. Both herbs play a role in draining dampness and promoting urination， warming Yang and transforming Qi， being a representative herb pair used for treating external-contraction exterior syndrome and water retention inside. The review of ancient medical publications revealed that there were a large number of compound formulas containing Cinnamomi Ramulus-Alismatis Rhizoma for dispersing cold and removing dampness， which were widely used for thousands of years in clinical practice. Modern pharmacological studies have shown that the active pharmacological components of Cinnamomi Ramulus （cinnamaldehyde and cinnamic acid） and Alismatis Rhizoma （alisol A and 23-acetate alisol B） have anti-inflammatory， antiviral， and immunoregulatory effects and high safety. Qingfei Paidu decoction containing this herbal pair played an important role in fighting against COVID-19. Despite the extensive pharmacological studies on Cinnamomi Ramulus and Alismatis Rhizoma， few studies have been carried out regarding this herb pair. This paper summarizes the traditional Chinese medicine knowledge about Cinnamomi Ramulus and Alismatis Rhizoma in the treatment of external-contraction diseases and summarizes the chemical composition， pharmacological effects， toxicology and other aspects of the two herbs before and after compatibility， aiming to provide a reference for further research and clinical application.