OBJECTIVE To provide a reference for the definition of the legal attributes of the provincial Chinese herbal pieces processing norms and the improvement of legal expression for the drug standards in Drug Administration Law. METHODS Based on the legal evolution of local drug standards in China， the composition of national drug standards for Chinese herbal pieces and the composition of current provincial Chinese herbal pieces processing norms were analyzed； at the same time， based on the method of legal interpretation， the legal connotation of the provincial Chinese herbal medicine processing norms in Drug Administration Law was investigated. RESULTS & CONCLUSIONS In the practice of drug supervision， the provincial Chinese herbal pieces processing norms are essentially local drug standards. The newly revised Drug Administration Law defines the drug standards specifically， but does not stipulate the legal attribute of drug standards for the provincial Chinese herbal pieces processing norms， and there are certain legislative technical defects. It is suggested that when amending the Drug Administration Law， the legal attributes of the drug standards of the provincial Chinese herbal medicine processing norms should be clarified.

Objective To screen differentially-expressed circRNA in plasma exosomes of patients with non-small cell lung cancer(NSCLC)and verify its diagnostic value for NSCLC.Methods The plasma exosomes of six patients with NSCLC and six healthy people were analyzed by circRNA sequencing.The expression of hsa_circ_0052513 in plasma exosomes of 60 NSCLC patients and 60 healthy controls was detected by qRT-PCR.The expression level of hsa_circ_0052513 in plasma exosomes of NSCLC patients before and after surgery was detected by qRT-PCR.The correlation between the expression of plasma exosomal hsa_circ_0052513 and clinical data of patients with NSCLC was statistically analyzed.Results Sequencing results showed that the expression of hsa_circ_0052513 in the plasma exosomes of NSCLC patients was higher than that of healthy controls,and the results were confirmed by qRT-PCR.Hsa_circ_0052513 was decreased in patients with NSCLC after tumor resection(P<0.05).The high expression of plasma exosomal hsa_circ_0052513 in patients with NSCLC was correlated with tumor size,distant metastasis,and TNM stage of NSCLC(all P<0.05).The area under the curve of plasma exosomal hsa_circ_0052513 in the diagnosis of patients with NSCLC was 0.7904(P<0.0001).Conclusion Hsa_circ_0052513 is highly expressed in the plasma exosomes of patients with NSCLC and is related to tumor size,metastasis,and TNM stage.Hence,Hsa_circ_0052513 could be a new diagnostic marker for NSCLC.

ObjectiveTo investigate the pharmacological effect and metabolic mechanism of Linderae Radix on the intrauterine adhesion （IUA） rat model. MethodAn IUA rat model was induced by mechanical injury and infection. Molecular biology and pharmacology techniques were employed to evaluate the inhibitory effect of Linderae Radix extract （LAE） on fibrosis in IUA. Serum metabolomics analysis based on gas chromatography-mass spectrometry （GC-MS） was conducted to explore the metabolic regulation mechanism of LAE. ResultAnimal experiments showed that LAE significantly improved the morphology and structural damage of uterine tissue cells in the IUA rat model， promoted endometrial proliferation， vascular regeneration， and morphological recovery， inhibited the mRNA expression of transforming growth factor-β₁ （TGF-β₁）， Smad2， and Smad3， and increased the expression of Smad7 mRNA to suppress fibrosis. Additionally， LAE significantly suppressed the levels of estrogen （E₂）， follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， and tumor necrosis factor-α （TNF-α） expression （P<0.01）， thereby improving the uterine microenvironment. Metabolomics analysis revealed significant metabolic abnormalities in the serum of IUA rats compared with the results in the normal group， and nine differential metabolites were identified. LAE effectively ameliorated these metabolic abnormalities， primarily by influencing six differential metabolites， including five shared metabolites among the nine identified markers： L-aspartic acid， L-pyroglutamic acid， L-serine， glucose， and L-norvaline. Pathway enrichment analysis indicated that the aminoacyl-tRNA biosynthesis pathway was the main affecting mechanism. ConclusionIn combination with the pharmacological research results， LAE effectively improved uterine damage and inhibited fibrosis in the IUA rat model. Its mechanism may involve the inhibition of the aminoacyl-tRNA biosynthesis pathway and the improvement of the microenvironment.

Objective:To analyze the clinical features of bronchiectasis in children after severe adenovirus pneumonia and to provide clinical clues for the early diagnosis of bronchiectasis in children after severe adenovirus pneumonia.Methods:A retrospective study was made to analyze the clinical data of 26 children with bronchiectasis after severe adenovirus pneumonia treated in Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from May 2016 to May 2021.Results:A total of 26 cases were reported, including 18 males and 8 females.The median onset age of severe adenovirus pneumonia was 23.0 (15.0, 48.0) months.A total of 23 cases suffered concurrent infections, and bacterial co-infection was the most common (16 cases). High resolution computed tomography (HRCT) showed multiple lobar solids in the lung with/without pleural effusion.During the acute phase, most of the cases were treated with intravenous immunoglobulin (21 cases), mechanical ventilation (20 cases), and systemic glucocorticoids (19 cases). The median age at diagnosis of bronchiectasis was 29.5 (21.0, 56.8) months, and the median time that the patients took to develop into acute adenovirus pneumonia was 6.0 (3.3, 13.0) months.Six cases suffered bronchiectasis alone, and 20 cases had bronchiectasis combined with post-infectious bronchiolitis obliterans (PIBO). Of these 20 cases, 3 cases developed bronchiectasis and PIBO simultaneously, and the remaining 17 cases developed bronchiectasis after PIBO.In the included 26 cases, diffuse bronchiectasis predominated (24 cases), most frequently involving the left lower lobes (21 cases) and right lower lobes (21 cases). Cylindrical bronchiectasis was the most common type (23 cases). All the patients had recurrent cough and wheezing during follow-up, and only 3 cases coughed up pus sputum without hemoptysis.All children had acute exacerbations, which were mostly caused by bacteria (21 cases). Nineteen cases combined with PIBO and 1 case with only bronchiectasis were rehospitalized.There was no cases of surgical resection or death.Conclusions:Bronchiectasis after severe adenovirus pneumonia mostly occurs in patients with or without PIBO.Multiple lobe involvement and co-infection may be a risk factor for PIBO patients to develop bronchiectasis.The clinical manifestations are mostly recurrent cough and wheezing, while sputum and hemoptysis are less common.Pediatricians should promptly perform chest HRCT for early diagnosis of the disease.

Objective To compare the surgical effect of gasless endoscopic thyroidectomy and CO2- insufflation endoscopic thyroidectomy, and evaluate the safety and applicability of gasless endoscopic thyroidectomy. Methods A prospective randomized controlled study was carried out.Sixty patients who were scheduled for bilateral thyroid surgery under endoscope were divided into 2 groups by sortition method: gasless group (30 patients, treated with gasless endoscopic thyroidectomy) and CO2-insufflation group (30 patients, treated with CO2-insufflation endoscopic thyroidectomy). The data of arterial partial pressure of carbon dioxide (PaCO2) and pH value before operation and 60 min after operation were detected. The operation time, intraoperative bleeding, time of putting the drain, hospitalization time after operation and postoperative complications were recorded. Results All the 60 patients completed endoscopic surgery,and no case was converted to the conventional procedure.There were no statistical differences in PaCO2and pH value before operation between 2 groups(P>0.05).The PaCO260 min after beginning of operation in gasless group was significantly lower than that in CO2-insufflation group:(36.43 ± 1.98)mmHg(1 mmHg=0.133 kPa)vs.(37.93 ± 3.27)mmHg,the pH value 60 min after beginning of operation was significantly higher than that in CO2-insufflation group:7.42 ± 0.02 vs. 7.37 ± 0.01, and there were statistical differences (P<0.05 or <0.01). There were no statistical difference in operation time, intraoperative bleeding, time of putting the drain, hospitalization time after operation and incidence of hoarseness between 2 groups (P>0.05). There were no complications related with trachea, parathyroid gland and superior laryngeal nerve in 2 groups. The incidence of CO2retention related complications in gasless group was significantly lower than that in CO2-insufflation group: 6.7% (2/30) vs. 43.3% (13/30), and there was statistical difference (P<0.01). Conclusions The modified spring suspension gasless endoscopic thyroidectomy not only acquires the equivalent surgical effect and indication,compared with the CO2-insufflation endoscopic surgery,but also is safer and has lower incidence rate of CO2retention related complications.

Objective To analyze the clinical and anatomic characteristics of bridging bronchus (BB) malformation in children,and to explore its diagnostic strategy,treatment and risk factors.Methods A retrospective study was performed in 23 pediatric patients with BB who were admitted to Guangzhou Women and Children's Medical Center form May 2010 to October 2016.All their clinical features,imaging examination,treatment and prognosis were reviewed and analyzed.Results (1) Among the 23 patients with BB,15 were males and 8 were females.The age range of onset was 0 to 4 years old with a median age of 3.17 months.(2)The main clinical manifestations were cough (23/23 cases,100.0％),recurrent wheezing (20/23 cases,87.0％),cyanosis (8/23 cases,34.8％) and feeding diffficulty/slow body weight growth (6/23 cases,24.6％).(3) There were 17 cases of type Ⅰ and 4 cases of type Ⅱ according to Wells,and the other 2 cases were anterior BB.There were 2 cases with atypical anatomical morphology in type Ⅰ and type Ⅱ respectively.(4) Twenty-one cases were associated with bronchial stenosis in which the origin of left main bronchus complicated with BB stenosis was the most common(5 cases).Bronchoscopy revealed bronchomalacia in 5 of the 16 patients.Sixteen patients associated with cardiac or vascular anomalies,11 of whom were compound anomalies,and the most common type was sling left pulmonary artery (SLPA) (12 cases).(5) Nine of 12 patients with SLPA received surgical management,ages ranging from 1 month to 8 years old.The respiratory symptoms remitted gradually or disappeared from 4 to 17 months after surgical management.Two died and one has been lost to follow-up among the remaining 3 patients with SLPA.Conclusions BB is a rare tracheobronchial malformation that is often associated with stenosis or bronchomalacia,and cardiac or vascular anomalies.The severity of the disease mainly depends on whether there is airway stenosis or malacia and its extent.The definitive diagnosis of BB requires the combination of different imaging modalities.The combination with simple SLPA could get better curative effect.

Objective To evaluate the relationship between different Framinghan vascular risk factor and cognitive impairment in the middle-aged and elderly.methods 71 participants from Physical Examination Center,Zhongnan Hospital of Wuhan University were consecutively recruited from March 2016 to May 2016.Framingham Cardiovascular Disease Risk Profile (FCVDRP),Framingham Stroke Risk Profile (FSRP) and Framingham Coronary Heart Disease Risk Profile (FCHDRP) were respectively used to evaluate the vascular burden of the participants.Mini-mental state examination (MMSE) and digital sign conversion test (DST) were used to evaluate the cognitive function of the participants.Partial correlation analysis was used to investigate the correlation between FCVDRP,FSRP and FCHDRP scoring methods and cognitive function.Result s(1)After adjusting for education years,with the increase of vascular burden scores,the scores of MMSE (FCVDRP:low-risk group (28.29±1.38),mid-risk group(27.40±1.73),high-risk group (26.72±1.93);FSRP:low-risk group (28.00±1.60),mid-risk group (26.26±2.46),high-risk group (27.2±2.04);FCHDRP:low-risk group (27.74±1.73),mid-risk group (27.46±2.00),high-risk group (27.18±1.59)) and DST (FCVDRP:low-risk group (29.24±5.54),mid-risk group (27.40±1.73),high-risk group (26.72±6.76);FSRP:low-risk group (30.09±5.61),mid-risk group (25.11±7.55),high-risk group (23.53±5.60);FCHDRP:low-risk group (30.37±6.41),mid-risk group (25.46±6.76),high-risk group (26.82±5.99)) were significantly decreased(all P<0.05).(2)The Result s of partial correlations analysis showed that the scores of FSRP were significantly correlated with MMSE (r=-0.249) and DST (r=-0.291)(both P<0.05).Conclusion Aggregation of vascular risks factors may aggravate cognitive impairment in middle-aged and elderly people.Compared to FCVDRP and FCHDRP,FSRP assessment may be more significantly associated with vascular cognitive impairment.

Objective To present our experience with management of craniopharyngiomas by endoscopic endonasal approach Methods A retrospective review of clinical data of 65 patients who were treated for craniopharyngiomas by endoscopic endonasal approach from February 2012 to May 2016. All patients were analyzed by treatment effect, complications, and follow-up result. Results Total removal of the tumors were completed in 52 cases (80.0%), subtotal removal in 11 cases (16.9%), and partial resection in 2 cases (3.1%). The pituitary stalks were identified in 57 cases when surgery, and severed in 41 cases (71.9%). Postoperative visual acuity was improved in 31 cases (47.7%), and 6 cases remained in the preoperative level, whereas worsening occurred in 1 case. Worsening of the anterior pituitary function was reported in 21 cases (32.3%). Transient diabetes insipidus after operation was occurred in 45 patients (69.2%), and long-term diabetes insipidus was occurred in 9 cases (13.8%). Postoperative cerebrospinal fluid (CSF) leak was occurred in 4 cases (6.2%), accompanied with intracranial infection, and all these cases were repaired under endoscope again, 3 cases were saved, but 1 case was dead. Perioperative mortality rate was 4.6%. 52 patients were followed up for 4.0 ~ 45.0 (mean, 20.8) months, and 44 patients (84.6%) returned life to normal. Obesity developed in 8 patients (15.4%), with 2 recurrent cases and no deaths during follow-up period. Conclusion The endoscopic endonasal approach is a safe and effective minimally invasive surgery approach for treating craniopharyngiomas, and has its own unique advantage.

Objective To explore the efficacy of sulfasalazine for treatment for epilepsy induced by gliomas .Methods The patients with epilepsy caused by gliomas in neurosurgery department were recruited from March 2006 to December 2013 .Epilepsy was controlled with sulfasalazine .The efficacy of sulfasalazine for treatment for epilepsy induced by glioma were analyzed to calcu-late the 50% response rate ,75% response rate and seizure-free rate .Meanwhile the outcomes scores of therapy of sulfasalazine for varieties types of epilepsy were evaluated ,according to the end result of scoring criteria in epileptic seizures .Results A total of 31 patients were controlled with sulfasalazine .The average reduction rate of seizure frequency per month was 54 .32% ,61 .71% , 75 .74% after three months of treatment .The differences of average reduction rate of seizure frequency before and after the treat -ment have an evident statistic significance (P< 0 .01) .The 50% response rate ,75% response rate and seizure-free rate per month af-ter treatment with sulfasalazine have significant higher than those before treatment (F= 20 .007 ,P< 0 .01) .After 3 month of thera-py ,four different types of epilepsy was 100 .00% ,100 .00% ,84 .62% and 75 .00% in improvement rate added complete control rate .Those have no statistical difference(P> 0 .05) .Conclusion Sulfasalazine can effectively control seizures ,and both effective va-rious types of epileptic .

Objective To explore the protective effect of Mn (Ⅲl)tetrakis (4-benzoic acid) porphyrin (MnTBAP) on rats after intracerebral hemorrhage (ICH) and its mechanism.Methods Sixty-six adult SD rats were randomized into sham-operated group,control group and experimental group (n=22).Rats in the latter two groups were performed stereotactic injection of autologous tail arterial blood to induce ICH models;the rats in the experimental group were given 2 μL MnTBAP (100 μg/μL) by intracerebroventricular injection 30 min after ICH,while the rats in the control group were given normal saline of same volume.The expressions of 4-hydroxynonenonal (4-HNE,a marker of lipid peroxidation),3-nitrotyrosine (3-NT,a reliable marker of protein nitration),8-hydroxy-2'-deoxyguanosine (8-OHdG,a marker of DNA oxidative damage),Zonula occludens-1 (ZO-1,a kind of tight junction protein) and myeloperoxidase (MPO,a marker of neutrophil) in the perihematomal brain tissues 24 h after ICH were detected by immunofluorescence;protein expressions of ZO-1 and matrix metalloproteinase-9 (MMP-9) were detected by Western blotting 24 h after ICH;brain water content and modified neurological severity (mNSS) scores were measured 24 and 72 h after ICH.Results As compared with those in the control group,3-NT (264.53±83.99vs413.22±89.16),4-HNE (245.64±73.10vs 391.41±51.43),8-OHdG (221.53±68.25 vs 332.32±94.93),MPO (296.14±66.34 vs 431.59±102.68) and MMP-9 (0.75±0.07 vs 0.96±0.04) expressions in perihematomal brains of experimental group were significantly decreased,while the expressions of ZO-1 (0.74±0.05 vs 0.56±0.06) were significantly increased (P＜0.05).The mNSS scores (9.33±1.37 vs 11.33±1.51;6.17±0.98 vs 9.50±1.38) and brain water contents in the experimental group were significantly lower as compared with those in the control group 24 and 72 h after ICH (80.41％±0.69％ vs 82.48％±0.94％;79.78％±0.65％ vs 81.57％±0.82％) (P＜0.05).Conclusion MnTBAP could protect injured brain tissues by alleviating oxidative and nitrative stress,decreasing neutrophils invasion and MMP-9 activation at early stage of ICH;meanwhile,MnTBAP could relieve the blood-brain barrier disruption and neurological deficit following ICH.