Objective To compare the clinical efficacy of herbal ion application and penetration therapy applied in the dog days, or in both of the dog days and coldest days for the treatment of recurrent respiratory tract infection (RRTI) in children. Methods This intervention was designed as a multi-center, randomized, single-blind, repeated-measurement design. A total of 240 RRTI children were randomly divided into Sanfu group (N=120, herbal ion application and penetration therapy applied in the dog days) and Fujiu group (N=120, herbal ion application and penetration therapy applied in both of the dog days and coldest days). Each group was treated for one year and then was followed up for one year. Before and after the treatment, we observed the frequency of respiratory tract infection, the period of onset, signs and symptoms of traditional Chinese medicine (TCM), and detected the salivary secretory immunoglobulin A (sIgA) at different time points. Results (1) The therapeutic effect of Fujiu group was better than that of Sanfu group, and the difference was significant (P<0.05). (2) The frequency of respiratory tract infection was reduced, the period of onset was shortened, and TCM signs and symptoms were improved in both groups, and the effect of Fujiu group was superior to that of Sanfu group (P<0.05). (3) Salivary sIgA showed a continuous upward trend in Fujiu group while a mild downward trend in Sanfu group at different time points (P<0.05). Conclusion Herbal ion application and penetration therapy applied in both of the dog days and coldest days shows better effect for the treatment of children RRTI than that applied only in the dog days.

Objective:This study aims to evaluate the sonographic features of phyllodes tumors of the breast (PTBs) and the cor-relation between sonographic and pathologic findings to improve the understanding of the disease. Methods:Sonographic findings of 85 PTBs from 83 patients were reviewed. The sonographic findings included the results of two-dimensional ultrasound and color Dop-pler flow imaging, elastographic features, and pathologic data. Results:Of the 85 lesions, 33 were the benign tumors, 28 were border-line, and 24 were malignant according to the pathologic diagnosis. Tumor morphology revealed that most masses were lobulated, with a clear-cut boundary, smooth verge, and inhomogeneous internal echo. Clear boundary was more common in the benign phyllodes tumors (χ2=12.721, P=0.002), and a cystic echo-free area was more commonly observed in these malignant tumors (χ2=9.677, P=0.046). LevelⅡandⅢsignals of the blood flow were observed in 75.3%of PTB cases. Of all lesions, only 26 were subjected to elasticity imaging, and the elastographic scores ranged from 2 to 3 in 88.5%of the cases (23/26). Conclusion:Conventional ultrasound and elastographic findings on PTBs exhibited definite characteristics. The border and cystic areas in the tumors can be used to differentiate between be-nign and malignant PTBs.

As the important components of peripheral nerve tissue, Schwann cells and macrophages interact with each other throughout the whole process of nerve regeneration. They play a key role in Wallerian degeneration, myelin clearance, axonal regeneration and target organ reinnervation in promotion of the repair of a peripheral nerve. In order to improve the simple strategy in treatment of peripheral nerve injury (PNI), great attention about the significance interaction mechanism between Schwann cells and macrophages in the process of nerve regeneration should be paid, as well as the continuous improvement in researches on the repair mechanism of a PNI. Trauma Centre, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine summarises the interaction mechanism of Schwann cells and macrophages in the regeneration of PNI through literature reviews, from 2015 to 2023, on the mechanisms of Schwann cells and macrophages in PNI repair, hence to draw new ideas in the research and clinical treatment of PNI.

Objective:To investigate the prognosis of pediatric arterial ischemic stroke(PAIS).Methods:We retrospectively analyzed the clinical data of patients aging from 1 month to 18 years old who were diagnosed with PAIS at the Emergency Department of Beijing Children′s Hospital from July 2015 to April 2020.We used the modified Rankin scale(MRS)to evaluate patients.We analyzed their recovery of neurological function, mortality rates, and the recurrence of PAIS, while statistically calculating the risk factors leading to disability and death caused by PAIS.Results:A total of 101 children with PAIS were involved.During the follow-up period, 32.7%(33/101)had no obvious neurological sequelae(MRS 0), and 24.8%(25/101)had mild symptoms that did not affect the patients′daily life(MRS 1). The proportion of mild disability(MRS 2)and moderate to severe disability(MRS 3-5)were 13.9%(14/101)and 9.9%(10/101), respectively.Notably, 18.8%(19/101)of the patients died during the follow-up period, and PAIS-related fatality rate was 7.9%.Of the 49 patients with MRS score of 1-5, 89.8%(44/49)had dyskinesia, 16.3%(8/49)had language disorder, 10.2%(5/49)had epilepsy, 10.2%(5/49)had intellectual impairment, and 4.1%(2/49)had memory impairment.Four children relapsed during the follow-up period.Infantile onset, cardiogenic stroke, consciousness disorder and multiple angiopathy may be the risk factors of severe disability and death of PAIS.Conclusion:PAIS has a certain probability of mortality and disability.Infantile onset, complicated with consciousness disorder, cardiogenic stroke and multiple angiopathy are risk factors for poor prognosis.

Objective To systematically explore the traditional Chinese medicine(TCM)common symptoms,syndrome elements,clinical syndrome differentiation,and medication rules of coronary microvascular disease(CMVD),and to provide a reference for quantitative criteria of clinical differentiation of CMVD,specification of the diagnosis and efficacy evaluation of TCM clinical syndrome,and guidance of clinical medication.Methods The databases including CNKI,Wanfang,VIP,and SinoMed were searched for research papers on the treatment of CMVD by TCM published from database inception to May 16,2023.Relevant information of the included literature was extracted and the database was established.Then,the frequency statistics of symptoms,syndrome elements,syndrome types and Chinese medicinals were carried out.Latent structural models were constructed using Latern 5.0 and Rstudio softwares respectively for comprehensive clustering and association rule analysis,so as to explore the symptom characteristics,syndrome elements distribution,common syndromes and medication rules for TCM treatment of CMVD.Results A total of 107 literature were included,involving 36 syndromes,17 syndrome elements,121 symptoms and 143 Chinese medicinals.It was speculated that the main syndrome element of CMVD was blood stasis,followed by qi deficiency,qi stagnation,phlegm turbidity,yin deficiency and yang deficiency.The main type of syndrome was qi deficiency and blood stasis,followed by heart blood stasis obstruction,qi stagnation and blood stasis,phlegm blended with stasis,qi-yin deficiency,etc..The main medicinals were Chuanxiong Rhizoma,Salviae Miltiorrhizae Radix et Rhizoma,Angelica Sinensis Radix and Astragali Radix.The medicinals used in the treatment of CMVD were classified as blood-activating and stasis-resolving drugs,deficiency-tonifying drugs,qi-regulating drugs in terms of their efficacy.Conclusion The location of CMVD is in heart,and related to liver and kidney.The syndrome of CMVD is deficiency in origin and excess in superficiality.Blood stasis runs through the development of the disease.The treatment is mainly to activate blood circulation and remove stasis,activate meridians and relieve pain,which should be supplemented with the therapies of tonifying and invigorating qi,soothing the liver and regulating qi,dispelling phlegm and dissipating masses according to the patients'syndromes.