The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

Medical linear accelerator is precisely large-scale medical equipment with high integration and complex construction.In use,it is easy to occur fault,and the maintenance process is tedious,and the cost of maintenance is higher.The servicers with medical engineering technique should proficiently know and grasp the structure and principle of this kind of equipment,and respond routine fault,and ensure the quality of accelerator in clinical application.This article analyzed a case of interlocking fault of stand power supply(STPS)of 23EX medical linear accelerator in the department of medical engineering of the Affiliated People's Hospital of Ningbo University.According to the performance of accelerator's fault,and combining the work principle of occurring STPS interlocking fault,the pulse width modulation(PWM)board in auxiliary electronic cabinet of accelerator was located.Its schematic diagram was analyzed and checked.Finally,it was determined that the reason was the field effect tube of PWM board was broken down.The fault was eliminated after the components of occurring fault was replaced.We can increase maintenance efficiency and technical level,and reduce the cost of maintenance for hospital,and ensure its quality in clinical application through quickly locate and resolve faults.

Objective To explore the causal association between immune cells and allergic rhi-nitis using Mendelian randomization(MR)approach.Methods GWAS data for 731 types of im-mune cells and allergic rhinitis were obtained from genome-wide association study(GWAS)databas-es.A two-sample bidirectional MR analysis was conducted,with the inverse-variance weighted(IVW)method as the primary analytical approach,and the weighted median method,MR-Egger re-gression,simple mode method,and weighted mode method as supplementary approaches.Sensitivity analyses,including heterogeneity tests,pleiotropy tests,and the leave-one-out method,were per-formed.Bonferroni correction was applied to the preliminary results to enhance their reliability and rigor.Results The two-sample forward MR analysis revealed correlations between 67 immune cell phenotypes and allergic rhinitis.After Bonferroni correction,four immune cell phenotypes were finally identified.Among them,the expression of CD3 on CD39-positive activated CD4 regulatory T cells(OR=0.953,95％CI,0.931 to 0.978,P＜0.001,Padj=0.007),the expression of herpesvirus entry mediator(HVEM)on CD45RA-negative CD4+T cells(OR=0.965,95％CI,0.948 to 0.983,P＜0.001,Padj=0.008),and the percentage of human leukocyte antigen class DR(HLA-DR)-high-expressing monocytes among leukocytes(OR=0.929,95％CI,0.885 to 0.974,P=0.002,Padj=0.157)were protective factors for allergic rhinitis.In contrast,the percentage of transitional B cells among B cells(OR=1.094,95％CI,1.032 to 1.161,P=0.003,Padj=0.183)was a risk factor for allergic rhinitis.The reverse MR analysis showed no causal relationship between allergic rhinitis and the four immune cell phenotypes.Conclusion The two-sample forward MR analysis confirms a caus-al link between immune cells and allergic rhinitis.MR analysis has the advantages of reducing con-founding factor interference and avoiding reverse causation,providing a theoretical basis for in-depth research on immune mechanisms,sensitive biomarkers,and drug treatment targets of allergic rhinitis.

Medical linear accelerator is precisely large-scale medical equipment with high integration and complex construction.In use,it is easy to occur fault,and the maintenance process is tedious,and the cost of maintenance is higher.The servicers with medical engineering technique should proficiently know and grasp the structure and principle of this kind of equipment,and respond routine fault,and ensure the quality of accelerator in clinical application.This article analyzed a case of interlocking fault of stand power supply(STPS)of 23EX medical linear accelerator in the department of medical engineering of the Affiliated People's Hospital of Ningbo University.According to the performance of accelerator's fault,and combining the work principle of occurring STPS interlocking fault,the pulse width modulation(PWM)board in auxiliary electronic cabinet of accelerator was located.Its schematic diagram was analyzed and checked.Finally,it was determined that the reason was the field effect tube of PWM board was broken down.The fault was eliminated after the components of occurring fault was replaced.We can increase maintenance efficiency and technical level,and reduce the cost of maintenance for hospital,and ensure its quality in clinical application through quickly locate and resolve faults.

Objective To investigate the causal association between bronchial asthma and bone mineral density at different sites using a two-sample Mendelian randomization (MR) approach. Methods Summary data for exposure factors and outcome were obtained from different genome-wide association studies.Single nucleotide polymorphisms strongly associated with bronchial asthma were selected as instrumental variables,and those in linkage disequilibrium were excluded.The inverse-variance weighted (IVW) method was used as the primary method for MR analysis,complemented by weighted median,simple mode,weighted mode,and MR-Egger regression methods.Sensitivity analyses were conducted to assess the stability of the results. Results The random-effects model of IVW analysis showed that heel bone mineral density (OR=0.986;95% CI,0.974 to 0.998;P=0.023) as the outcome dataset had a reverse causal effect with bronchial asthma,while lumbar spine bone mineral density (OR=1.031;95% CI,0.984 to 1.081;P=0.195),femoral neck bone mineral density (OR=1.014;95% CI,0.973 to 1.057;P=0.505),and forearm bone mineral density (OR=1.011;95% CI,0.935 to 1.094;P=0.775) as outcome datasets showed no causal effect with bronchial asthma.The MR-Egger intercept test results indicated that the P-values for the intercepts of lumbar bone mineral density,femoral neck bone mineral density,forearm bone mineral density,and calcaneal bone mineral density were all over 0.05,suggesting no horizontal pleiotropy and relatively stable results. Conclusion MR analysis reveals a reverse causal effect between bronchial asthma and heel bone mineral density,suggesting that clinicians should strengthen the monitoring of heel bone mineral density in patients with bronchial asthma to timely detect and intervene osteoporosis.

Objective:To explore the effects of respiratory resistance training combined with active cycle of breathing techniques in nursing care for patients with lower cervical spinal cord injury.Methods:From April 2017 to March 2019, we selected 78 patients with lower cervical spinal cord injury in Trauma Emergency Center of the Third Affiliated Hospital of Hebei Medical University as subjects. All patients were divided into observation group and control group with the method of random number table, 39 cases in each group. Control group carried out the respiratory system nursing with the self-developed compound sequential technology on sputum exclusion. On the basis of that in control group, observation group implemented the resistance inspiratory training and expiratory training with the respiratory resistance training combined with active cycle of breathing techniques. We compared the volume of sputum excretion, pulmonary function[forced vital capacity (FVC) , forced expiratory volume in one second (FEV1) , peak expiratory flow (PEF) and maximal expiratory pressure (MEP) ] and incidences of pulmonary complications during hospitalization between two groups.Results:A total of four weeks after training, the volume of sputum excretion of observation group on the fifth day after surgery was lower than that of control group with a statistical difference ( P<0.05) . There were four pulmonary function indexes (FVC、FEV1、PEF、MEP) in observation group better than those in control group with statistical differences ( P<0.05) . The incidence of pulmonary complications of observation group was lower than that of control group with a statistical difference ( P<0.05) . Conclusions:Respiratory resistance training combined with active cycle of breathing techniques can promote the early excretion of sputum of patients with lower cervical spinal cord injury, improve the pulmonary function and reduce the incidence of pulmonary complications.

ObjectiveTo establish a rat model of nerve damage induced by intrathecal(IT) lidocaine.MethodsFifty-five adult male SD rats weighing 200-220 g were randomly divided into 5 groups (n =11 each):group normal control (group C); group dimethyl sulfoxide (DMSO)-the solvent(group D) and groups IT 5％,10％,15％ lidocaine (groups L5.10.15 ).IT catheter was successfully implanted without complication in groups D,L5,L1o,L15.DMSO,5％,10％ and 15％ lidocaine 20 μl were injected IT in groups D,L5,L10,L15 respectively.Motor dysfunction of hindlimb was assessed and scored (0 =normal,2 =complete block) and paw withdrawal threshold to mechanical stimulation (von Frey filaments) (MWT) and paw withdrawal latency to thermal nociceptive stimulus (TWL) were measured before (baseline) and at 1,2,3,4,5,7 d after IT administration in 8 animals in each group.Three animals in each group were sacrificed at 1 d after IT administration.The lumbar segment (L4-5) was removed for microscopic examination.ResultsThere was no significant difference in motor dysfunction score,MWT and TWL among groups C,D and L5.MWT was significantly increased and TWL prolonged at 1 and 2 d after IT administration in group L10,while in group L15 motor dysfunction score was significantly increased at 1,2 d after IT administration and MWT was significantly increased and TWL prolonged at 1,2,3 d after IT administration.There was significant histologic damage to spinal cord in groups L10 and L15.Conclusion Nerve damage can be induced by IT 10％ lidocaine.

Purpose To construct a recombined antitumor peptide and to analyze its bioactivity. Methods Constructing a recombined gene and inserting the pGEX-4T-3 vector. The recombined protein was expressed in E. coli BL21 and purified with Amylose Resin. Then, citrostatin was subjected to the following tests separately: inhibition of endothelial cell proliferation, MTT test of cytotoxicity and inhibition of endothelial cell tube formation on ECMatrix. Results Citrostatin significantly inhibited the proliferation of human endothelial cell ECV304(IC_(50) = 2.28 μmol/L) .It also significantly inhibited the proliferation of human tumor cell 1990 and NCI-H64O(IC_(50) = 9.24,2.74 μmol/L) ,and the inhibitory effect became more marked with the increase of citrostatin concentration. The inhibitory effects of citrostatin on endothelial cell tube formation was also confirmed . Conclusion An antitumor peptide, citrostatin, has been successfully constructed and purified, which showed anti-angiogenesis effect and direct cytotoxic effect on tumor cells.

Objective To study the profiles of decompression sickness(DCS) in various kinds of animals and to find out the target organ of decompression sickness by providing a basic experimental method for establishing animal models.Method Eleven kinds of animals were exposed to different pressures for different times at different compression/decompression rates.They were monitored at the precordial regions with Doppler flow meter for bubble sounds after decompression to normal pressure,to obtain a record about the developing course of the DCS.Pathological examinations of the bulbar conjunctiva were also made. Result Bubble sound of grade IV were recorded at the precordial regions after decompression.Among them,75%~100% incurred DCS with a diverse extent. Animals developed DCS showed vascular spasm,dysfunction and endothelial tumefaction.Conclusion Each of the 11 kinds of animals can serve as a model of DCS and the processes of development of DCS in various animals are similar.Blood vessels are the target organs of decompression sickness.

Objective To compare the effect of different partition of nucleic acid protein complex on the affinity of enriched library in systematic evolution of ligands by exponential enrichment (SELEX). Methods Two protocols were adopted to select the enriched library to transforming growth factor ? receptor Ⅱ(TGF ? RⅡ). Protocol 1: protein was absorbed on the surface of 96 well plate; then, selection was carried out; the binding nucleotide acids were eluted from the supporter directly. Protocol 2: selection was done in solution; nucleotide acid protein complex was captured in nitrocellulose membrane; the binding nucleotide acids were obtained from membrane. Filter biding assay and gel shift assay were performed to detect the affinity of the enriched ssDNA library from different protocols. Results After 4 rounds of selection, the affinity to TGF ? RⅡ was obviously improved in the enriched library from protocol 2 compared with the initial library, while no such improvement was found in the enriched library from protocol 1. Conclusion In the SELEX experiment, the way of selection in solution, then partition of the binding nucleotide acids in filter is easier to enrich the binding fragment from initial ssDNA random library, compared with the way of fixation of target protein to solid supporter, then selection between the solid phase and liquid phase and elution of the binding nucleotide acids from supporter.