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.

Objective:To investigate the effect of early pulmonary rehabilitation (PR) training on the improvement of respiratory function in patients with acute respiratory distress syndrome (ARDS) after weaning of invasive mechanical ventilation in the intensive care unit (ICU).Methods:The retrospective cohort research method was used. The clinical information of adult patients with ARDS receiving invasive mechanical ventilation admitted to the ICU of Qingdao Municipal Hospital from January 2019 to March 2023 was collected. The patients were divided into a control group and an observation group according to off-line training program. The control group received traditional training after weaning, and the observation group received the early PR training after weaning. Other treatments and nursing were implemented according to the routine of the ICU. The scores of the short physical performance battery (SPPB) on day 3-day 6 of the weaning training, respiratory muscle strength, level of interleukin-6 (IL-6), number of aspirations of sputum after weaning, length of stay after weaning, rehospitalization rate within 6 months after discharge, and pulmonary function indicators at discharge and 3 months after discharge [peak expiratory flow (PEF), forced expiratory volume in one second/forced vital capacity ratio (FEV1/FVC), and vital capacity (VC)] of the two groups of patients were compared. The Kaplan-Meier survival curve was drawn to analyze the cumulative survival rate of patients 6 months after discharge.Results:A total of 50 of which 25 cases received the traditional training after weaning, 25 cases received the early PR training after weaning. There was no significant difference in gender, age, acute physiology and chronic health evaluationⅡ (APACHEⅡ), oxygenation index upon admission, etiological diagnosis of ARDS upon admission, time of invasive ventilation, mode of invasive mechanical ventilation, pulmonary function indicators at discharge, and other baseline data of the two groups. The SPPB questionnaire scores and respiratory muscle strength in both groups were increased gradually with the extended offline training time, the serum level of IL-6 in both groups were descend gradually with the extended offline training time, especially in the observation group [SPPB questionnaire score in the observation group were 7.81±0.33, 8.72±0.53, 9.44±0.31, 10.57±0.50, while in the control group were 7.74±0.68, 8.73±0.37, 8.72±0.40, 9.33±0.26, effect of time: F = 192.532, P = 0.000, effect of intervention: F = 88.561, P = 0.000, interaction effect between intervention and time: F = 24.724, P = 0.000; respiratory muscle strength (mmHg, 1 mmHg≈0.133 kPa) in the observation group were 123.20±24.84, 137.00±26.47, 149.00±24.70, 155.40±29.37, while in the control group were 129.00±20.34, 126.00±24.01, 132.20±25.15, 138.60±36.67, effect of time: F = 5.926, P = 0.001, effect of intervention: F = 5.248, P = 0.031, interaction effect between intervention and time: F = 3.033, P = 0.043; serum level of IL-6 in the observation group were 80.05±6.81, 74.76±9.33, 63.66±10.19, 56.95±4.72, while in the control group were 80.18±7.21, 77.23±9.78, 71.79±10.40, 66.51±6.49, effect of time: F = 53.485, P = 0.000, effect of intervention: F = 22.942, P = 0.000, interaction effect between intervention and time: F = 3.266, P = 0.026]. Compared with the control group, the number of aspirations of sputum after weaning of patients in the observation group significantly decreased (number: 22.46±1.76 vs. 27.31±0.90), the length of ICU stay after weaning significantly became shorter (days: 6.93±0.95 vs. 8.52±2.21), and the rehospitalization rate within 6 months after discharge significantly decreased [20.00% (5/25) vs. 48.00% (12/25)]. There were significant differences. The pulmonary function indicators 3 months after discharge of two groups of patients significantly increased compared with those at discharge and those of the observation group were significantly higher than those of the control group [PEF (L/min): 430.20±95.18 vs. 370.00±108.44, FEV1/FVC ratio: 0.88±0.04 vs. 0.82±0.05, VC (L): 3.22±0.72 vs. 2.74±0.37, all P < 0.05]. The Kaplan-Meier survival curve showed that the cumulative survival rate of patients 6 months after discharge of patients in the observation group was significantly higher than that of patients in the control group [76.9% vs. 45.5%, hazard ratio ( HR) = 0.344, P = 0.017]. Conclusion:Early PR training can significantly improve the respiratory function of patients with ARDS after weaning of invasive mechanical ventilation. Continuous active respiratory training after discharge can improve the respiratory function of patients and effectively decrease mortality.

Objective:To explore the possible of clinical application value after transferred with day 3 extremely low-grade cleavage-stage embryos during in vitro fertilization and embryo transfer. Methods:The clinical outcomes of four cases with extremely low-grade cleavage-stage embryos on day 3 undergoing IVF-ET were retrospectively analyzed and the related literatures were reviewed.Results:Four cases successfully got pregnant after 12 days of transplantation of extremely low-grade embryos detected by human chorionic gonadotropin testing, and all of them were intrauterine singleton pregnancies. Finally these four patients had successful live births, and three of them were full-term delivery, one of them was delivery prematurely. All the babies were in the good health.Conclusion:There is still a degree of successful pregnancy and live birth rate after transferred with day 3 extremely low-grade cleavage-stage embryos. If the quality of all the embryos was extremely low-grade on day 3, we can provide new attempts and choices for the patients who were often giving up embryos transfer.

Objective:To explore the possible of clinical application value after transferred with day 3 extremely low-grade cleavage-stage embryos during in vitro fertilization and embryo transfer. Methods:The clinical outcomes of four cases with extremely low-grade cleavage-stage embryos on day 3 undergoing IVF-ET were retrospectively analyzed and the related literatures were reviewed.Results:Four cases successfully got pregnant after 12 days of transplantation of extremely low-grade embryos detected by human chorionic gonadotropin testing, and all of them were intrauterine singleton pregnancies. Finally these four patients had successful live births, and three of them were full-term delivery, one of them was delivery prematurely. All the babies were in the good health.Conclusion:There is still a degree of successful pregnancy and live birth rate after transferred with day 3 extremely low-grade cleavage-stage embryos. If the quality of all the embryos was extremely low-grade on day 3, we can provide new attempts and choices for the patients who were often giving up embryos transfer.

Breast cancer is the second malignant tumor of female reproductive system.With the development of modern medical imaging technology,conventional ultrasound and mammography are the most popular methods in breast examination and cancer screening.While CT,MRI and nuclear medicine diagnosis act as the additional methods of breast cancer diagnosis.In addition,CEUS and biopsy might be used in diagnosis of lesion lacking imaging characteristics.The imaging methods in diagnosis of breast lesions were reviewed in this paper.

Rheumatoid arthritis (RA) is a chronic aseptic inflammatory disease characterised by synovial inflammation leading to progressive joint involvement with joint swelling,tenderness,and functional impairment.After therapeutics,some patients still have persistent synovitis and structural damage while they are in clinical remission.Musculoskeletal ultrasonography (MSUS) is playing a more important role in diagnose,therapy monitoring and prognosis of RA in the case of its character-non-invasive,easy to accept,cost-effective,and repeatable examination in the short term,especially multiangle of all aspects in the interesting area.Application of grey scale ultrasonography,power doppler ultrasonography,CEUS in RA clinical remission and evaluation on the therapeutic effect and prognosis were reviewed in this article.

Objectives:To explore the relationship between sleep quality and coping styles in cervical cancer patients undergoing radiotherapy.Methods:68 cervical cancer patients were assessed by convenient sampling,who had been investigated with Pittsburgh Sleep Quality Index (PSQI) and Jalowiec coping scale (JCS-60).Results:Global PSQI score was (8.60 ± 4.47).Optimistic coping scored highest with score of (2.11 ± 0.45),which was the style most often applied by cervical cancer patients.Emotive coping scored lowest with score of (0.97 ± 0.62).Among 60 coping items,Hoped that things would get better was the most often used coping strategy,Took a drink to make yourself feel better was the least used coping strategy.Global PSQI score was positively correlated with fatalistic coping(r =0.325,P =0.008).Confrontive coping was positively correlated with subjective sleep quality score(r =0.318,P =0.009),while supportive coping was negatively related to subjective sleep quality score(r =-0.306,P =0.013),and palliative was negatively related to daytime dysfunction(r =-0.245,P =0.047).Gonclusions:Sleep problems are a common complaint in cervical cancer patients undergoing radiotherapy.Health care workers should guide the patients to adopt active coping styles to improve sleep quality.

Objective To explore the effect of infrared scanning temperature gun in geriatrics department. Methods A total of 200 cases of elderly patients were divided into control group with mercury thermometer ( armpit) and the test group with infrared scanning temperature gun ( armpit,mild forehead, neck, neiguan) . The time of measuring temperature and sterilization, and the effects on measuring temperature were compared. Results The time of measuring temperature and sterilization in the test group were (0. 1 ± 0. 0) and (0. 5 ± 0. 0 ) min, which were significantly shorter than those of the control group ( t = 20. 61, 49. 71, respectively;P<0. 01). There was a significant difference in the forehead temperature measured by infrared scanning temperature gun and the armpit temperature measured by mercury thermometer (P<0. 05). However, there was no significant difference in the armpit, neck and neiguan temperature measured by infrared scanning temperature gun and the armpit temperature measured by mercury thermometer (P>0. 05). Patients and nurses were more likely to the neck and neiguan measuring by infrared scanning temperature gun. Conclusions The stability and accuracy of infrared scanning temperature gun measuring neck and neiguan is same as the mercury thermometer.

Objective To investigate the auditory condition in adults with hearing-impairment and evaluate the outcome of the hearing aid. Methods The threshold of air-bone-conduction audiometry and binaural hearing aid in 91 adults were determined with pure tone audiometry,and their satisfaction to hearing aids were investigated with free interview. Results The threshold of hearing and hearing aid were positively correlated. The satisfaction did not significantly correlate with the threshold of hearing aid, but with the time of deprivation of hearing. The hearing threshold classification was better in the patients with the audiogram of flat, raising, slow down type than with audiogram of Shu type, which defined as hearing reacted only in 1 or 2 frequency. Conclusion It is important to improve the primary otology protection, as well as the rehabilitation from the hearing aids.

The aim of the present study was to evaluate the effect of storage conditions,pretreatment,temperature,time and excystation solutions on in vitro excystation of Cryptosporidium oocyst.Cryptosporidium andersoni oocyst was used as a model and the results showed that 0.5% sodium hypochlorite could enhance the excystation rates.But there was no significant difference compared with oocysts untreated by sodium hypochlorite(P＞0.05).0.75% synthetic sodium taurocholate and 1% bile solution could urge the excystation of oocysts,which were significantly different compared with the excystation rate of oocysts in 0.25% trypsin solution or in PBS(P<0.05).The excystation rates of oocysts in acidic water (pH =3) were similar with the rates in PBS (pH =7.2) but significantly different from the rates in alkaline water (pH =9) (P<0.01).Additionally,the excystation rate of oocysts in water of 24℃ was significantly lower than in water of 37℃(P<0.01),and the excystation rate of oocysts raised gradually at 37℃ with the passage of time.It's concluded that temperature,acidity and excystation solution were vital factors for the in vitro excystation of Cryptosporidium oocyst.A higher excystation rate could be observed when oocysts were pretreated with 0.5% sodium hypochlorite and treated with 0.75% synthetic sodium taurocholate at 37℃ for 3 hours.