Objective:To evaluate the efficacy and safety of Xiao′er Huangjin Zhike Granules in the treatment of cough caused by acute bronchitis in children, which is defined in TCM terms as a syndrome of phlegm-heat obstructing the lung.Methods:This was a block-randomized, double-blind, placebo-controlled, multicenter clinical trial.From January 2022 to September 2023, 359 children aged 3 to 7 years old diagnosed as acute bronchitis (lung-obstructing phlegm-heat syndrome) were enrolled from 21 participating hospitals and randomly assigned to the experimental group and placebo group in a 3︰1 ratio, and respectively treated with Xiao′er Huangjin Zhike Granules and its matching placebo.Cough resolution/general resolution rate after 7 days of treatment was used as the primary efficacy outcome for both groups.Results:(1)On the seventh day of treatment, the rate of cough disappearance/basically disappearance in the experimental group and placebo group were 73.95% and 57.61% retrospectively, which had statistically significance ( P=0.001).(2)After 7 days of treatment, the median duration of cough disappearance/basic disappearance were 5 days and 6 days in the two groups , with a statistically significant difference ( P=0.006).The area under the curve of cough symptom severity time was 7.20 ± 3.79 in the experimental group and 8.20±4.42 in the placebo group.The difference between the two groups was statistically significant ( P=0.039).(3) After 7 days of treatment, the difference between TCM syndrome score and baseline was -16.0 (-20.0, -15.0) points in the experimental group and -15.0 (-18.0, -12.0) points in the placebo group, with significant difference between the two groups ( P=0.004).In the experimental group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 49.04%, 28.35%, 16.48% and 6.13% severally; and in the placebo group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 38.04%, 26.09%, 29.35%, and 6.52% separately, which had statistically significant ( P=0.014).(4) There was no significant difference in the incidence of adverse events or adverse reactions during the trial between both groups.Moreover, while adverse reactions in the form of vomiting and diarrhea were occasionally reported, no serious drug-related adverse event or adverse reaction was reported.(5)The tested drug provided good treatment compliance, showing no statistically significant difference from the placebo in terms of compliance rate. Conclusions:Based on the above findings, it can be concluded that Xiao′er Huangjin Zhike Granules provides good safety, efficacy, and treatment compliance in the treatment of cough caused by acute bronchitis, and lung-obstructing phlegm-heat syndrome, in children.

Humans ; Electronic Health Records ; Phenotype ; Renal Insufficiency, Chronic/epidemiology* ; Databases, Factual ; Algorithms

Objective:To explore the expression levels and the clinical significance of serum secreted frizzled-related protein 5 (SFRP5) and miR-124-3p in patients with hypertension during pregnancy.Methods:Ninety-eight patients with hypertension during pregnancy diagnosed from Jan. 2019 to Feb. 2022 were selected as the observation group. According to the degree of the condition of patients, they were divided into 41 cases of pregnancy hypertension, 32 cases of mild preeclampsia, and 25 cases of severe preeclampsia, and 80 healthy subjects during the same period were selected as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression level of serum SFRP5 in patients, real-time fluorescence quantitative method (qRT-PCR) was used to detect the expression level of miR-124-3p. The relationship between SFRP5, miR-124-3p levels and clinicopathological indicators in patients with hypertension in pregnancy was analyzed, Pearson correlation analysis was used to analyze the correlation between SFRP5 and miR-124-3p. Multivariate Logistic regression was used to analyze the risk factors of hypertension in pregnancy.Results:Compared with the control group, the serum SFRP5 expression level of the observation group [ (33.78±5.21) ng/L vs (43.34±8.56) ng/L] was down-regulated, while the miR-124-3p level [ (2.16±0.41) vs (1.01±0.17) ] was up-regulated, and the serum SFRP5 level of the observation group decreased with the severity of the disease[ (38.43±6.37) ng/L (33.18±5.14) ng/L (26.94±3.38) ng/L], while the level of miR-124-3p increased with the severity of the disease[ (1.62±0.24) (2.19±0.43) (3.01±0.69) ], the difference was statistically significant ( P<0.05) . The expression levels of SFRP5 and miR-124-3p in the serum of patients with hypertension in pregnancy were related to the age, pregnancy, pre-pregnancy BMI, and fasting blood glucose level of patients ( P<0.05) , but not related to the gestational age of patients ( P>0.05) . Bioinformatics TargetScan website showed that SFRP5 and miR-124-3p had binding sites. Pearson correlation analysis showed that SFRP5 and miR-124-3p were negatively correlated ( r=-0.610, P<0.05) . Multivariate Logistic regression analysis showed that SFRP5 was a protective factor for pregnancy-induced hypertension in pregnant women, and miR-124-3p was a risk factor ( P<0.05) . Conclusion:The serum levels of SFRP5 and miR-124-3p are abnormally expressed in patients with hypertension during pregnancy, and there is a certain relationship with the degree of disease. Both are involved in the occurrence and development of hypertension during pregnancy.

Objective:To explore the features the gait of elderly persons with type 2 diabetes and peri-pheral neuropathy.Methods:Twenty patients no less than 60 years old with type 2 diabetes and peripheral neuropathy (DPN) formed a DPN group, while 20 counterparts with type 2 diabetes but without peripheral neuropathy composed the DM group, and another 20 healthy counterparts served as a control group. The three groups were tested using the Swedish Qualisys motion capture system and their walking speed, step length, step width, stride frequency and stride length, bipedal foot support phase time, single foot support phase time, peak plantar pressure, and regional-holding time were collected and compared.Results:The average walking speed, stride length and stepping frequency of the DPN group were all significantly lower than the other 2 groups′ averages. Their bipedal support phase was significantly longer, but their single foot support phase time was significantly shorter. And in the DPN group the average first and second peak plantar pressures and the second peak pressure time were significantly greater than the other groups′ averages.Conclusions:Elderly patients with type 2 diabetes and peripheral neuropathy have significant gait abnormalities, decreased walking stability, as well as increased plantar pressure and plantar compression time.

Objective:To discuss the correlation between the immune instability of Th17/Treg and the pathogenesis of the Henoch-Schonlein purpura(HSP)with Mpcoplasma pneumoniae(MP)infection.Methods:From June 2018 to December 2019, children who had been diagnosed as HSP in the Department of Pediatrics at Qinhuangdao First Hospital and Qinhuangdao Maternal and Child Health Care Hospital, as well as in-patients with MP infection and outpatients, who had health check-up were collected.The subjects were divided into HSP group(41 cases), MP group(25 cases), HSP-MP group(19 cases) and control group(20 cases) according to the diagnosis of HSP and MP infection.The percentage of Th17 and Treg cells in peripheral venous blood of four groups were determined by flow cytometry, and the levels of interleukin(IL)-17, IL-6 and transforming growth factor-β(TGF-β)in peripheral venous serum of four groups were detected by ELISA.Results:There were no statistically significant differences regarding age and gender distribution among four groups( P>0.05). The percentages of Th17 cells, IL-17 and IL-6 levels in peripheral blood of the HSP-MP group was significantly higher than those in the other three groups( P<0.05), which in HSP group and MP group were higher than that in control group( P<0.05). There was no statistical difference between HSP group and MP group( P>0.05). The percentage of Treg cells in peripheral blood was significantly lower in HSP-MP group than those in the other three groups( P<0.05), which in the HSP group and MP group were lower than those in control group( P<0.05). There was no statistical difference between HSP group and MP group( P>0.05). There were no statistically significant differences of TGF-β among the four groups( P>0.05). Conclusion:High levels of IL-17 and IL-6 may be an important factor causing severe Th17/Treg immune disorders in children with HSP combined with MP infection, which may play an important role in the pathogenesis of HSP combined with MP infection.

Objective:To explore the clinical effect of endoscopic assisted or microscopical transsphenoidal surgery in the treatment of different grades of invasive pituitary tumors and the measures to reduce complications.Methods:From January 2016 to June 2019, 87 patients with pituitary tumor admitted to the neurosurgery of Tangshan People′s Hospital of Hebei Province were selected as the study objects for retrospective analysis. Among them, 42 patients were included in the endoscopic group and 45 patients were included in the endoscopic group. To compare the related indexes and clinical effects of two different surgical methods, and to analyze the treatment strategies to reduce the common postoperative complications.Results:The amount of intraoperative bleeding, the time needed for operation and the hospital stay of patients in endoscopic group were significantly less or shorter than those in microscopical group(intraoperative bleeding volume: (66.19±9.55) ml and (79.78±11.68) ml; operation time: (93.93±9.53) min and (103.33±9.23) min; hospitalization time: (7.71±1.53) d and (10.16±1.33) d). The difference was statistically significant (T values were 5.92, 4.67, 7.94, all P< 0.01). There was no significant difference between the two groups ( P= 0.577). There were 2 cases (4.8%) of cerebrospinal fluid leakage in endoscopic group and 12 cases (26.7%) in microscopical group. The difference between the two groups was statistically significant(χ 2=5.67, P< 0.05). There were 7 cases (16.7%) of diabetes insipidus in endoscopic group and 22 cases (48.9%) in microscopical group. The difference between the two groups was statistically significant (χ 2=5.19, P< 0.05). Conclusion:The curative effect of endoscopic transsphenoidal resection of pituitary tumor is similar to that of microscopical resection of pituitary tumor. The patients recover quickly, have fewer complications, and have a short hospital stay.

Objective:To explore the effects of WeChat-based health education on management of hypertensive outpatients under medical consortium.Methods:Totally 180 hypertensive patients who attended the Multidisciplinary Clinics of Beijing Anzhen Hospital, Capital Medical University, and Datun Community Health Service Center from communities under our medical consortium from November 2018 to April 2019 were selected and divided into the observation group ( n=91) and the control group ( n=89) according to the visit time. Patients in the control group received routine health education, while patients in the observation group received WeChat-based health education under medical consortium for 6 months. The self-management ability (using Hypertension Patients Behavior Rating Scale, HPSMBRS) , treatment compliance (using Therapeutic Adherence Scale for Hypertensive Patients, TASHP) , the 24 h average systolic and diastolic blood pressure, the average systolic and diastolic blood pressure at daytime, and the average systolic blood pressure and diastolic blood pressure at night were compared between the two groups. Results:After the intervention, the diet management, medication management, disease monitoring, exercise management, work and rest and emotional management scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . After the intervention, the medication-taking behavior, bad medication-taking behavior, daily activity management behavior and tobacco and alcohol addiction scores were higher than those of the control group, and the differences were statistically significant ( P<0.05) . After the intervention, the 24 h average systolic and diastolic blood pressure, average systolic and diastolic blood pressure at daytime and average systolic and diastolic blood pressure at night decreased in the observation group, and the differences were statistically significant compared with the control group ( P<0.05) . Conclusions:The WeChat platform under medical consortium provides standardized, consistent, continuous and effective health education, which can improve the self-management ability and treatment compliance of hypertensive outpatients, and can effectively control blood pressure levels. It shows sound effects in clinical use.

Foodborne Campylobacter is recognized as the leading causes of the bacterial diarrheal illness in both developing and developed countries. C. jejuni and C. coli caused 95% of the human campylobacterisosis. Bacteria culture has been recognized as the "Gold standard" for the diagnosis of the Campylobacter infection. The National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention coordinated the experienced researchers from China National Center for Food Safety Risk Assessment and other local Centers for Disease Control and Prevention to write up the standards for entitled Isolation and Identification of Campylobacter jejuni and Campylobacter coli (T/CPMA 006-2019). The standard is drafted with principles of emphasizing the scientific, normative, applicability and feasible nature. This group standard recommended the procedures and steps for the isolation and identification of C. jejuni and C.coli from variant samples. The standard aims to improve the capacity for Campylobacter identification in China.

Objective:In this study,a prokaryotic expression of the 3-ketosteroid-Delta (1)-dehydrogenase (KSDD) which came from Arthrobacter simplex was built.Moreover,in order to investigate the catalytic mechanism of KSDD and improve its stability,the structure of KSDD was predicted by computer and the critical sites were confirmed by site-directed mutations.Methods:The recombinant plasmid was constructed by eukaryotic expression vector pET-22b and the recombinant strain was constructed and expressed in Escherichia coli BL21 (DE3).High-performance liquid chromatography was used to determine the transformation rate of 4-AD to ADD.The KSDD structure and key sites were predicted by SWISS-MODEL.Site-directed mutations for the amino acid residues of key sites were constructed and activities of the mutations were detected.Results:The recombinant strain E.coli pET-22-ksdd was successfully constructed.It was induced to express the dehydrogenase by IPTG and the conversion rate of 4-AD to ADD was 27％ at 21 ℃.The structure of 3-ketosteroid-Delta (1)-dehydrogenase and the four key sites was analyzed by SWISS-MODEL.Four mutants,Y120R,Y320L,Y488F and G492Y were constructed.Mutants Y120R and Y488F were inactivated,so they were proved to be the key active sites of KSDD.The conversion rate of mutant Y320L was consistent with that of wild type,but the stability at 37 ℃ was improved.The conversion rate of mutant G492Y was 1.2 times of the wild type and the stability has been improved at 37 ℃.Conclusions:At present,there are few studies about the structure and catalytic mechanism of dehydrogenase.The active sites of the enzyme were verified by this study,which laid the foundation for the further study of the properties of the enzyme KSDD.

Objective:To observe the clinical function of Chinese medicine enema liquid combined with antibiotics in syndrome differentiation typing treatment of chronic pelvic inflammation. Methods:A total of 240 patients with chronic pelvic inflammation were randomly divided into the control group(120)and the observation groups(120)including damp-heat stasis accumulation type,qi stagnation and blood stasis type and cold-dampness accumulation type. The patients in the control group received 0. 2g levofloxacin hydrochloride with intravenous drip,twice a day for 14 days,while those in the observation groups were given 250ml Chinese medicine enteroelysis(damp-heat stasis accumulation type was given Baiyi enteroelysis,qi stagnation and blood stasis type was given Puyao enteroelysis,and cold-dampness accumulation type was given Baiyao enteroelysis )with irrigation treatment once a day additionally. The patients in the observation group were given enteroelysis three or five days after menstruation and continued for 14 days,and the treatment course was two menstrual cycles. The indices of hemorheology and clinical efficacy were compared after the treatment between the groups. Results:The total effective rate in the observation group (91. 7% )was higher than that in the control group(81. 7% )(P < 0. 05). The improvement of whole blood viscosity,plasma viscosity,fibrinogen,erythrocyte sedimentation rate and platelet aggregation rate in the observation group were better than those in the control group(P < 0. 05). Conclusion:Chinese medicine enteroelysis shows obvious curative effect in the treatment of chronic pelvic inflammatory diseases,and combined with antibiotics,the effect can be strengthened,which is worthy of clinical application.