Objective To investigate the clinical efficacy of Shufei Huatan Decoction in the treatment of children with chronic cough of phlegm-dampness accumulating in lung type and to observe its inflammatory regulatory effect.Methods A total of 116 children with chronic cough of phlegm-damp accumulating in lung type who were treated in the outpatient or inpatient departments of Dongguan Hospital,Guangzhou University of Chinese Medicine from February 2022 to February 2024 were randomly divided into the observation group and the control group,with 58 cases in each group.The control group was treated with conventional western medicine of antibiotics and antihistamines,while the observation group was treated with Shufei Huatan Decoction,a self-formulated Chinese medicine prescription.The course of treatment covered two weeks and then the patients were followed up for four weeks.Before and after treatment,the changes of scores of cough,expectoration,and pulmonary auscultation findings,levels of type 2 inflammatory factors of interleukin 4(IL-4)and total immunoglobulin E(IgE),and indicators of airway inflammation such as Eotaxin,fractional exhaled nitric oxide(FeNO)of the two groups were observed.After treatment,the clinical efficacy,the incidence of adverse reactions and the recurrence rate of the children in the two groups were compared.Results(1)After two weeks of treatment,the total effective rate of the observation group was 94.83%(55/58)and that of the control group was 86.21%(50/58),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)After treatment,the scores of cough,expectoration,and pulmonary auscultation findings as well as their total scores in the two groups were decreased compared with those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.05).(3)After treatment,the levels of inflammatory factors of FeNO value and serum Eotaxin,IL-4,and total IgE of the two groups were decreased compared with those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.05).(4)The incidence of adverse reactions in the observation group was 8.62%(5/58)and that in the control group was 5.17%(3/58),and the intergroup comparison showed that the difference was not statistically significant(P>0.05).(5)The four-week follow-up showed that the recurrence rate in the observation group was 3.64%(2/55)and that in the control group was 10.00%(5/50),and the difference was not statistically significant between the two groups(P>0.05).Conclusion Shufei Huatan Decoction exerts certain efficacy in treating children with chronic cough of phlegm-damp accumulating in lung type,which is effective and safe on significantly improving children's clinical symptoms,reducing the release of inflammatory factors,and inhibiting the inflammatory reactions.

Objective To observe the effect of Zha's manipulation combined with muscle energy technique(MET)on neck and shoulder pain and Neck Disability Index(NDI)of patients with second and third cervical facet joint disorders,and then to find out a precise,safe and effective therapies for the its treatment.Methods A randomized controlled trial was conducted for 60 patients with second and third cervical facet joint disorders who met the inclusion criteria.The patients who admitted to the outpatient clinic of the Rehabilitation Department of Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine from June 2023 to July 2024 were randomly divided into a treatment group and a control group,with 30 patients in each group.The treatment group was given the treatment of Zha's manipulation combined with MET,and the control group was given conventional tuina therapy.The treatment was performed once a day and the course of treatment covered five consecutive treatments.The changes of Visual Analogue Scale(VAS)scores of pain and NDI scores in the two groups before and after treatment were observed.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)During the treatment,there were no fell-off cases in the two groups,and all patients completed the whole course of treatment.(2)After five days of treatment,the total effective rate of the treatment group was 96.7％(29/30),and that of the control group was 86.7％(26/30);the intergroup comparison(tested by rank sum test)showed that the therapeutic efficacy of the treatment group was significantly superior to that of the control group(P＜0.05).(3)After treatment,the VAS scores of neck pain in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of the VAS scores of neck pain in the treatment group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the NDI scores for evaluating the cervical vertebra function in the two groups were significantly improved compared with those before treatment(P＜0.05),and the improvement of NDI scores in the treatment group on was significantly superior to that in the control group(P＜0.05).Conclusion Zha's manipulation combined with MET therapy can effectively alleviate pain and improve the cervical vertebra function of patients with second and third cervical facet joint disorders,and its therapeutic efficacy is superior to that of conventional tuina therapy.

Objective:To investigate the therapeutic efficacy of Golimumab in the treatment of children with refractory juvenile dermatomyositis(JDM).Methods:The clinical data of a child diagnosed with JDM in the Department of Allergy, Immunology and Rheumatology of Guangzhou Women and Children′s Medical Center in February 2019 were collected.The treatment effect was studied and literature review was conducted.Results:The patient was a 7-year-old boy with subacute onset of the disease.The illness protracted, and main manifestations included skin rashes, limb weakness, and swallowing dysfunction.Physical examination showed heliotropic rashes, Gottron papules, positive Gower, proximal limb muscle strength grade Ⅲ-Ⅳ, distal limb muscle strength grade Ⅳ, and a choking cough when swallowing fluid food.Laboratory tests revealed alanine aminotransferase (ALT) of 36 U/L, aspartate aminotransferase (AST) of 115 U/L, alkaline phosphatase of 69 U/L, lactate dehydrogenase of 941 U/L, creatine kinase of 974 U/L, hypersensitive C-reactive protein of 26 mg/L and an erythrocyte sedimentation rate (ESR) of 52 mm/1 h. Antinuclear antibody spectra were negative.Electromyography suggested myogenic damage.Thigh magnetic resonance imaging indicated diffuse abnormal signal shadows in the subcutaneous fat, muscles and muscle spaces of both hips, thighs and knee joints.The child was diagnosed with JDM, and given standardized treatment of Methylprednisolone, intravenous immunoglobulin, Methotrexate and Hydroxychloroquine sulfate.However, after the treatment, the facial rashes were still red, proximal limb muscle strength and swallowing dysfunction did not improve, the choking cough symptom still existed, and a Cushing face appeared.Recheck results showed ALT of 24 U/L, AST of 32 U/L, alkaline phosphatase of 56 U/L, lactate dehydrogenase of 216 U/L, creatine kinase of 527 U/L, hypersensitive C-reactive protein of 8 mg/L and an ESR of 15 mm/1 h. Refractory JDM was considered.After negotiating with the patient′s family members, they agreed to treat the patient with Golimumab 50 mg by subcutaneous injection once a month.Then tapered prednisone gradually, stopped Hydroxychloroquine sulfate tablets and continued to give the patient oral Methotrexate.After two doses of Golimumab 50 mg, proximal limb muscle strength and swallowing function improved markedly.After the third subcutaneous injection of Golimumab, proximal limb muscle strength improved to grade Ⅳ-Ⅴ, and he was able to go up and down stairs, squat and stand up after squatting.Besides, dysphagia and the choking cough disappeared, and skin rashes improved.Recheck results suggested a normal ESR and creatine kinase levels.Magnetic resonance imaging of thighs indicated no muscle inflammation.Conclusions:Golimumab works well in the treatment of refractory JDM and can effectively improve muscle strength.Therefore, it can be used as a treatment option for refractory JDM.

OBJECTIVE： To establish QAMS method for content determination of paeoniflorin， rutin， oroxin B， baicalin and cinnamates in Yanyan tablets. METHODS： HPLC method was adopted. The determination was performed on Hypersil GOLD-C18 column （250 mm×4.6 mm，5 μm） with mobile phase consisted of methanol-0.35％ phosphoric acid solution （gradient elution） at flow rate of 1 mL/min. The detection wavelengths were set at 280 nm （rutin， oroxin B， baicalin， cinnamates） and 230 nm （paeoniflorin）. The column temperature was 30 ℃， and sample size was 10 μL. Using paeoniflorin as internal reference， relative correction factors （RCF） of rutin， oroxin B， baicalin and cinnamates were established. Effects of different chromatogram system， chromatogram column， mobile phase proportion， flow rate and column temperature on relative correction factors were investigated； the chromatographic peaks of the components were located according to the relative retention time. The content of paeoniflorin as internal reference was determined by external standard method， and the other four components were determined by QAMS， and then compared with the results of external standard method. RESULTS： The separation degree of each component to be measured was greater than 1.5. The linear range was 3.97-119.22 μg/mL for paeoniflorin，1.96-58.68 μg/mL for rutin，2.39-71.64 μg/mL for oroxin B， 1.92-57.51 μg/mL for baicalin， 0.54-16.24 μg/mL for cinnamates（r≥0.999 7）， respectively. RSDs of precision， reproducibility and stability tests were all lower than 2％. Average recoveries were 97.20％-98.07％（RSD＜3％，n＝6）. RCFs of rutin， oroxin B， baicalin and cinnamates were 0.554 6，1.815 6，2.489 3 and 5.423 2， using paeoniflorin as internal reference. RSDs of RCF and relative retention time were all lower than 5％ under different chromatogram conditions. Absolut relative error of four components （except for internal reference） in 10 batches of Yanyan tablets sampled by QAMS and external standard method were all less than 1％. The results of the two methods were identical. CONCLUSIONS： The established method is accurate， rapid， efficient and inexpensive， and it can be used for simultaneous determination of 5 indicator components in Yanyan tablet.

Objective To evaluate the effect of compound glycyrrhizin on the prevention and cure of cytarabine syndromes. Methods A total of 130 patients with hematological malignancies treated by moderate or high dose of cytarabine in the 303th Hospital of PLA from July 2010 to July 2016 were included. Patients were randomly divided into the control group and the experiment group by using random number table method, and each group had 65 patients. In the control group, patients were treated with cytarabine alone. In the experiment group, patients were treated with cytarabine plus compound glycyrrhizin. Skin rash and fever in patients of the two groups were also recorded. Results of blood routine tests, liver and kidney function tests were monitored during the treatment. Results Sixty-one patients in the experiment group and 63 patients in the control group were enrolled finally. In experiment group and control group, the differences in the incidence of cytarabine syndromes [8.2 % (5/61) vs. 41.3 % (26/63), χ2＝ 18.1, P < 0.001], skin rash [1.6 % (1/61) vs. 12.7 % (8/63), χ2＝16.3, P <0.001], and fever [6.6 % (4/61) vs. 36.5 % (23/63), χ2＝5.63, P <0.017] were statistically significant. There was no significant difference of the incidence of liver injury and minimum blood cell count between the two groups (P＞ 0.05). Conclusion Compound glycyrrhizin can effectively reduce the incidence of cytarabine syndromes, but the larger size and multiple center studies are needed to further verify the effect.

Objective To evaluate postprandial pharmacokinetics and bioequivalence of two preparations of cefdinir capsules in Chinese healthy volunteers. Methods In a two-way cross-over study, 24 healthy male volunteers were divided into two groups randomly and a single dose of cefdinir capsules of test and reference preparation were administered orally, respectively.The concentration in plasma was determined by LC-MS/MS. Pharmacokinetic parameters and bioequivalence were calculated and evaluated by DAS. Results The main pharmacokinetic parameters of test and reference were as follows: AUCt (4.35±1.09) μg??h??mL-1 and (4.12±1.22) μg??h??mL-1, AUC0-∞(4.53±1.12) and (4.53±1.73) μg??h??mL-1, t1/2 (1.74±0.29) h and (2.13±1.65) h, tmax(4.44±0.86) h and (4.54 ±1.16) h, Cmax(900±250) ng??mL-1 and (876±269) ng??mL-1 . Conclusion The test and reference preparation of cefdinir capsules are bioequivalent.

Objective To investigate the value of hepatobiliary scintigraphy combined with total bile acid (TBA) and γ-glutamyhransferase(γ-GT) detection in the differential diagnosis of persistent jaundice induced by infantile hepatitis syndrome(IHS) and congenital extrahepatic biliary atresia(EHBA).Methods A retrospective analysis of 60 infants with persistent jaundice undertaking 99Tcm-diethylacetanilide iminodiacetic acid (EHIDA) hepatobiliary scintigraphy was done in Nanfang Hospital by single photon emission computed tomography(SPECT).Meanwhile,these infants' sera were collected and separately detected by AU5431 automatic biochemical assay;the sensitivity,specificity and accuracy of hepatobiliary scintigraphy with TBA and γ-GT were evaluated.Results The sensitivity to 99Tcm-EHIDA hepatobiliary scintigraphy in the diagnosis of IHS and EHBA were 100.00％ (17/17 cases) and 67.57％ (25/37 cases),the specificity was 67.57％ (25/37 cases) and 100.00％ (17/17 cases),and the accuracy was 77.78％ (42/54cases) and 77.78％ (42/54 cases),respectively.The levels of TBA and γ-GT were higher in infants with EHBA than those with IHS(U =209.0,19.5,all P ＜0.05),and ROC curve analysis indicated that TBA in the IHS group and γ-GT in EHBA group had some diagnostic value[area under curve (AUC) =0.736,0.968,respectively].99Tcm-EHIDA hepatobiliary scintigraphy combined with TBA and γ-GT analysis suggested when intestinal non-radioactive imaging was shown,TBA was 98.5 μmol/L and γ-GT was 298 U/L,the sensitivity,specificity and accuracy of diagnosis of EHBA were 100.00.00％ (17/17 cases),100.00％ (37/37 cases) and 100.00％ (54/54 cases) in a serial test.Conclusions Hepatobiliary scintigraphy combined with TBA and γ-GT examination can effectively identify EHBA and IHS earlier,noninvasively and safely,which have important role in further treatment in infants with persistent jaundice.

Objective To compare the volume of the basal ganglia in patients with Tourette syndrome(T S) and the normal volunteers and to explore the underlying anatomical basis of TS.Methods Thirty-one cases of TS (TS subjects),31 gender and age-matched subjects (the control subjects) were examined on a 3.0 T MRI system.The volume of the caudate nucleus,globus pallidus,putamen of the two sides and the brain volume were measured with volume analysis software,and the data were normalized according to the individual brain volume.Statistical analysis was performed using t test to compare between the TS subjects and the controls.Results The volume of the both sides of the caudate nucleus,putamen and globus pallidus of TS subjects were (4.11 ±0.12) and (3.76 ±0.11),(2.28 ±0.12)and(2.35 ±0.28),(4.98 ±0.20) and (4.89 ±0.31)cm3,while they were (4.88 ±0.19) and (4.30 ±0.12),(2.28 ±0.12)and (2.35 ± 0.28),(4.98 ± 0.20) and (4.89 ± 0.31) cm3 in the controls,respectively.There were significant differences in the bilateral caudate nucleus and globus pallidus between the TS subjects and control subjects (t =2.97,1.74,3.72,3.93,P ＜ 0.05),but there were no significant differences of the volume in the bilateral putamen between the TS and control subjects(t =0.47,1.31,P ＞0.05).The volume was not significantly different between the left and right caudate nucleus in the TS subjects (t =1.81,P ＞0.05),but the left volume of the caudate nucleus was bigger in the control subjects compared with the right volume,however,there was significant difference between the bilateral caudate nucleus in the control subjects (t =2.34,P ＜ 0.05).There were no differences of volume between the bilateral globus pallidus and putamen in both the TS and control subjects (t =1.12,1.44,1.68,0.38,P ＞ 0.05).Conclusion The abnormal volume of caudate nucleus,putamen,and the globus pallidus may be involved in the pathogenesis of TS.

OBJECTIVETo investigate the shielding effect of distance in radioactive iodine treatment in patients with differentiated thyroid cancer (DTC).

METHODSEighty-seven DTC patients underwent postoperative radioactive iodine treatment at the therapeutic doses ranging from 2.96 GBq to 7.4 GBq. The patients were divided into two groups to receive high-dose therapy (≥3.7 GBq, 48 patients) and low-dose therapy (<3.7 GBq, 39 patients). The radiation doses at 0.05 m, 1 m, and 3 m were recorded at different days; the doses at 1 m and 3 m on the third day, the dose of standard radioactivity source of 1.11GBq (131)I, and the natural background radioactivity were also recorded.

RESULTSThe radiation dose at a 1-meter distance was significantly higher in the high-dose group than in the low-dose group (P<0.05). The radiation doses in different dose groups at the other distances or at different time points showed no significant differences (P>0.05). On the third day after therapy, the radiation dose at 1 m was significantly lower than the reference radioactivity source of 1.11 GBq (131)I (P=0.000), but still higher than the natural background radioactivity at 3 m (P=0.000).

CONCLUSIONIn DTC patients who receive radioactive iodine therapy, the radioactive radiation dose decreases rapidly after 3 days. The radioactive radiation dose on the third day is significantly lower than the reference radioactive radiation dose, so that the patients can be discharged with safety for contact at a distance beyond one meter.

Adult ; Female ; Humans ; Iodine Radioisotopes ; therapeutic use ; Male ; Middle Aged ; Radiation Dosage ; Radiation Protection ; Thyroid Neoplasms ; radiotherapy

Objective To investigate the shielding effect of distance in radioactive iodine treatment in patients with differentiated thyroid cancer (DTC). Methods Eighty- seven DTC patients underwent postoperative radioactive iodine treatment at the therapeutic doses ranging from 2.96 GBq to 7.4 GBq. The patients were divided into two groups to receive high-dose therapy (≥3.7 GBq, 48 patients) and low-dose therapy (<3.7 GBq, 39 patients). The radiation doses at 0.05 m, 1 m, and 3 m were recorded at different days;the doses at 1 m and 3 m on the third day, the dose of standard radioactivity source of 1.11GBq 131I, and the natural background radioactivity were also recorded. Results The radiation dose at a 1-meter distance was significantly higher in the high-dose group than in the low-dose group (P<0.05). The radiation doses in different dose groups at the other distances or at different time points showed no significant differences (P>0.05). On the third day after therapy, the radiation dose at 1 m was significantly lower than the reference radioactivity source of 1.11 GBq 131I (P=0.000), but still higher than the natural background radioactivity at 3 m (P=0.000). Conclusion In DTC patients who receive radioactive iodine therapy, the radioactive radiation dose decreases rapidly after 3 days. The radioactive radiation dose on the third day is significantly lower than the reference radioactive radiation dose, so that the patients can be discharged with safety for contact at a distance beyond one meter.