Attention deficit hyperactivity disorder is a common neurodevelopmental disorder characterized by persistent attention deficit, hyperactivity, and impulsive behaviors that are not consistent with developmental age.Academic and vocational difficulties, social exclusion, and delinquent behaviors are manifested in daily life.It is also commonly accompanied by psychiatric problems.At the same time, mental problems are common, and the overall quality of life is greatly affected, placing a heavy burden on society as well as the family.International attention deficit hyperactivity disorder experts have developed a common and comprehensive International Classification of Functioning, Disability and Health core set of classifications for assessing individual functioning in attention deficit hyperactivity disorder.

ObjectiveTo investigate the value of percutaneous and intravenous contrast-enhanced ultrasound（P-Ⅳ-CEUS） in sentinel lymph nodes（SLNs） after resection of early-stage primary breast cancer. MethodsA retrospective analysis was done on the clinical and imaging data of 42 early breast cancer patients. Following primary tumor resection， all these patients underwent reoperation in our hospital. SLNs were examined by preoperative P-Ⅳ-CEUS and intraoperative sentinel lymph node biopsy（SLNB） was performed by using Methylene blue as a tracer. Then we analyzed the detection and false-negative rate in CEUS and SLNB respectively. By using the surgical pathological results as the gold standard， the diagnostic efficacy of CEUS for SLNs was explored. ResultsThe detection rate and false negative rate of SLNs in percutaneous contrast-enhanced ultrasound （P-CEUS） were 92.9% （39/42） and 7.1% （3/42）， respectively. The detection rate in methylene blue staining was 100% （41/41） and one patient underwent neoadjuvant therapy due to biopsy-confirmed metastasis. The sensitivity， specificity， positive predictive value， negative predictive value and accuracy of P-Ⅳ-CEUS were 66.7% （2/3）， 100% （37/37）， 100% （2/2）， 97.3% （36/37） and 97.4% （38/39）， respectively. ConclusionsP-Ⅳ-CEUS after resection of early-stage primary breast cancer can accurately detect SLNs and characterize their status， which is a reliable clinical basis for reducing invasive SLNB.

OBJECTIVES: To study the left heart structure and functional characteristics of term neonates with intrauterine growth restriction (IUGR). METHODS: This study included 86 term neonates with IUGR admitted to the Neonatal Ward of Beijing Friendship Hospital, Capital Medical University from January 2019 to January 2022 as the IUGR group, as well as randomly selected 86 term neonates without IUGR born during the same period as the non-IUGR group. The clinical data and echocardiographic data were compared between the two groups. RESULTS: The analysis of left heart structure and function showed that compared with the non-IUGR group, the IUGR group had significantly lower left ventricular mass, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left atrial diameter, end-diastolic interventricular septal thickness, left ventricular posterior wall thickness, left ventricular end-diastolic volume, left ventricular end-systolic volume, and stroke volume (P<0.05) and significantly higher ratio of end-diastolic interventricular septal thickness to left ventricular posterior wall thickness, proportion of neonates with a mitral peak E/A ratio of ≥1, and cardiac index (P<0.05). The Spearman correlation analysis suggested that stroke volume was positively correlated with birth weight and body surface area (r_s=0.241 and 0.241 respectively; P<0.05) and that the ratio of end-diastolic interventricular septal thickness to left ventricular posterior wall thickness was negatively correlated with birth weight and body surface area (r_s=-0.229 and -0.225 respectively; P<0.05). CONCLUSIONS The left ventricular systolic function of neonates with IUGR is not significantly different from that of neonates without IUGR. However, the ventricular septum is thicker in neonates with IUGR. This change is negatively correlated with birth weight and body surface area. The left ventricular diastolic function may be impaired in neonates with IUGR.
Humans ; Infant, Newborn ; Birth Weight ; Echocardiography ; Fetal Growth Retardation ; Heart ; Heart Ventricles/diagnostic imaging* ; Ventricular Function, Left

To scientifically evaluate the intervention effect of Chinese medicine preventive administration(combined use of Huo-xiang Zhengqi Oral Liquid and Jinhao Jiere Granules) on community population in the case of coronavirus disease 2019(COVID-19), a large cohort, prospective, randomized, and parallel-controlled clinical study was conducted. Total 22 065 subjects were included and randomly divided into 2 groups. The non-intervention group was given health guidance only, while the traditional Chinese medicine(TCM) intervention group was given two coordinated TCM in addition to health guidance. The medical instructions were as follows. Huoxiang Zhengqi Oral Liquid: oral before meals, 10 mL/time, 2 times/day, a course of 5 days. Jinhao Jiere Granules: dissolve in boiling water and take after meals, 8 g/time, 2 times/day, a course of 5 days, followed up for 14 days, respectively. The study found that with the intake of medication, the incidence rate of TCM intervention group was basically maintained at a low and continuous stable level(0.01%-0.02%), while the non-intervention group showed an overall trend of continuous growth(0.02%-0.18%) from 3 to 14 days. No suspected or confirmed COVID-19 case occurred in either group. There were 2 cases of colds in the TCM intervention group and 26 cases in the non-intervention group. The incidence of colds in the TCM intervention group was significantly lower(P<0.05) than that in the non-intervention group. In the population of 16-60 years old, the incidence rate of non-intervention and intervention groups were 0.01% and 0.25%, respectively. The difference of colds incidence between the two groups was statistically significant(P<0.05). In the population older than 60 years old, they were 0.04% and 0.21%, respectively. The incidence of colds in the non-intervention group was higher than that in the intervention group, but not reaching statistical difference. The protection rate of TCM for the whole population was 91.8%, especially for the population of age 16-60(95.0%). It was suggested that TCM intervention(combined use of Huoxiang Zhengqi Oral Liquid and Jinhao Jiere Granules) could effectively protect community residents against respiratory diseases, such as colds, which was worthy of promotion in the community. In addition, in terms of safety, the incidence of adverse events and adverse reactions in the TCM intervention group was relatively low, which was basically consistent with the drug instructions.
Adolescent ; Adult ; Betacoronavirus ; Coronavirus Infections ; drug therapy ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Pandemics ; Pneumonia, Viral ; drug therapy ; Prospective Studies ; Young Adult

Objetive To investigate the effect of Qingkailing injection on the expression of Toll-like receptor 4 (TLR4), gp91^phox and zonula occludens-1 (ZO-1) in cerebrovascular endothelial cells induced by hypoxia activation of microglias. Methods:BV2 microglia cells were divided into six groups. They were cultured in serum-free DMEM, while the Qingkailing groups of low, middle and high dosages were cultured with 0.0625%, 0.125% and 0.25% Qingkailing injection, respectively, and minocycline group with minocycline of 200 nmol/L. The groups other than control group underwent hypoxia for 24 hours and reoxygenation for 24 hours. Then, the medium of microglia was put into the medium of Balb/c endothelial cells for 24 hours. The cell viability of endothelial cells was measured with CCK-8, the concentration of nitric oxide (NO) was detected with colorimetry, and the experission of TLR4, gp91^phox and ZO-1 was detected with Western blotting. Results:Compared with the control group, the cell viability and the expression of ZO-1 decreased in the model group (P < 0.01), while the concentration of NO and the expression of TLR4 and gp91^phox increased (P < 0.05). Compared with the model group, the cell viability and the expression of ZO-1 increased in the Qingkailing groups and the minocycline group (P < 0.05), while the concentration of NO and the expression of TLR4 and gp91^phox decreased (P < 0.05). Conclusion:Qingkailing injection may enhance the survival and function of cerebrovascular endothelial cells by inhibiting the hypoxia activation of microglias, reducing the expression of TLR4 and gp91^phox, and increasing the expression of ZO-1.

OBJECTIVE:To investigate the basic situation of pharmaceutical staffs and the development of pharmaceutical care in Chongqing primary health care institutions,and to provide references for promoting the development of pharmaceutical work in primary health care institutions. METHODS:A questionnaire survey was conducted to investigate the basic situation of pharmaceutical staffs and the development of pharmaceutical care in primary health care institutions from 38 districts and counties of Chongqing,and the data was analyzed statistically to put forward suggestion. RESULTS:A total of 1147 questionnaires about the general situation of primary health care institutions were sent out,and 813 valid questionnaires were collected,with effective recovery rate of 70.88％. A total of 1972 questionnaires about the general situation of pharmaceutical staffs and the development of pharmaceutical care were sent out,and 1904 valid questionnaires were collected,with effective recovery rate of 96.55％. The average number of pharmaceutical staffs in the community health service center was 4.5(2-14 persons),that of pharmaceutical staffs in township hospitals was 2.5(0-12 persons),accounting for 8.69％ and 8.17％ of professional medical staffs,respectively. Some of respondents were part-time nonprofessionals. The highest educational level of surveyed pharmaceutical staffs was college degree (51.79％),followed by high school degree and secondary school degree (21.64％). The professional titles were mostly assistant pharmacists (34.35％),followed by pharmacists (30.04％). Only 2.73％ of the licensed pharmacist certificates were obtained,and no one obtained the clinical pharmacist training certificate of National Health and Family Planning Commission. In community health service center and township hospital,the higher proportion of the job positions of the pharmacists were in outpatient pharmacy(79.67％ and 81.44％),inpatient pharmacy (32.94％ and 56.57％),TCM pharmacy(27.54％ and 40.85％) and warehouse (22.20％ and 24.05％);the lower proportion of the job positions of the pharmacists were in clinicalpharmacy room(1.40％ and 0),laboratory(0.23％ and 0)and PIVAS(0.23％ and 0). Top 6 pharmaceutical care projects carried out by the community health service center included drug dispensing(100％),out-patient prescription comment(70.00％),ADR monitoring(62.67％),medication consultation(60.67％),antibiotics prescription comment(58.00％),medication education and medication guidance(50.00％);pharmaceutical outpatient service,therapy drug monitoring and pharmacogenomics detection were not developed. The pharmaceutical care projects carried out by township hospital included drug dispensing (100％),ADR monitoring (62.29％),medication consultation (59.73％),medication education and medication guidance (53.85％),outpatient prescription comment (51.58％),and antibiotics prescription comment (45.40％);centralized intravenous pharmacy admixture and administration, pharmaceutical outpatient service, therapy drug monitoring and pharmacogenomics detection were not developed. CONCLUSIONS:The pharmaceutical talents are short in Chongqing primary health care institutions and part-time staffs also have a certain proportion. The overall quality of pharmaceutical staffs is not high,and their professional skills and capabilities are limited. The institutions do not pay enough attention to pharmaceutical care, and the development of pharmaceutical care is not ideal. To promote the development of pharmaceutical care,primary health care institutions should pay more attention to pharmaceutical care,increase the investment of funds in combination with the actual situation,optimize post setting,perfect the construction of institutions,and strengthen the introduction and training of pharmaceutical staffs so as to constantly improve their professional level and pharmaceutical care capabilities,and provide high-quality,safe,humanized and professional pharmaceutical care.

Objective Thermal injury causes pulmonary edema, which may lead to acute respiratory distress syndrome, sepsis, multiorgan failure and even death. The article aimed to study the mechanism of curcumin pretreatment on inflammatory factors in lung tissues and serum endotoxin of rats with dry-heat environment.Methods A total of 50 SD rats were randomly divided into 5 groups (n=10): normal control group, dry heat control group, low concentraion group (50mg/kg curcumin pretreatment group), middle concentraion group (100mg/kg curcumin pretreatment group), and high concentration group (200mg/kg curcumin pretreatment group). Rats in normal control group and dry heat control group were given normal saline by gavage, while rats in 3 curcumin pretreatment groups were given curcumin of different concentrations (50 mg/kg, 100 mg/kg, 200 mg/kg) by gavage once a day for 7 consecutive days. At 8d, all the other 4 groups except normal control group were transferred to the climate cabin (The Simulated Climate Cabin for Special Environment of Northwest of China) with the condition of (41±0.5)℃, (10±1)% relative humidity.The rats were put in the dry-heat environment for 150min, then they were anaesthetized and sacrificed at 150min to collect the blood, lung tissues for further analysis. Observation was made on the pathological changes of lung tissues of rats in each group and the changes of inflammatory factors such as IL-1β, IL-6, TNF-α and LPS.Results Compared with dry heat control group, the concentrations of IL-1β, IL-6, TNF-α and LPS in normal control group, curcumin pretreatment groups with low concentration, middle concentration and high concentration were significantly higher(P<0.01). The concentrations of IL-1β, IL-6, TNF-α and LPS in curcumin pretreatment group with low concentration were significantly lower than those curcumin pretreatment groups with middle concentration and high concentration(P<0.05). Compared with curcumin pretreatment group with middle concentration, LPS concentration of curcumin pretreatment group with high concentration decreased significantly (P<0.01). Pearson correlation analysis showed that there was a positive correlation between the plasma of LPS and inflammatory cytokines of IL-1β, IL-6, and TNF-α in lung tissues (correlation coefficient r=0.866, r=0.900, r=0.885, P=0.000).Conclusion Curcumin inhibits bacterial endotoxin in blood, reduces the expression of inflammatory factors, and plays an important role in alleviating secondary multiple organ damage, which means curcumin pretreatment can relieve lung damage caused by heatstroke and reduce the mortality of heatstroke.

Objective To comprehensively evaluate the clinical efficacy,safety and economic benefits of atorvastatin and fluvastatin in regulating dyslipidemia.Methods The clinical randomized controlled trials (RCTs) for comparing clinical efficacy of atorvastatin and fluvastatin on regulating dyslipidemia were retrieved from databases,including Cochrane Library,PubMed,Medline,Embase,Wiley,Springer,CNKI,Wanfang and VIP,till June 2016.Data were evaluated by two reviewers independently according to the Jadad standard.The changes of low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),total cholesterol (TC) and triglyceride (TG) before and after treatment were extracted to perform Meta-analysis by using RevMan5.0 software.The economic evaluation was carried out,as well.Results A total of 7 RCTs were included,including 684 cases of patients treated with fluvastatin and 2 208 cases of patients treated with atorvastatin.The patients were spitted into two subgroups according to the same or different maximum dose of atorvastatin and fluvastatin.The results indicated that the effects of atorvastatin on down-regulating LDL-C,TC and TG levels were significantly better than those of fluvastatin,the differences were statistically significant (Z=23.63、23.32、5.50,P＜0.000 01).No significant difference was found in regulating HDL-C level between atorvastatin and fluvastatin.Conclusion Compared with fluvastatin,atorvastatin is more effective to regulate levels of LDL-C,TC and TG,but there is no significant difference in up-regulating HDL-C level.Additionally,application of atorvastatin is more economicallv effective.

Objective To investigate the characteristics of traditional Chinese medicine(TCM) constitution of patients with metabolic syndrome(MS), so as to provide individualized therapy for the treatment and rehabilitation of MS. Methods The data of a total of 328 MS patients were collected, covering body height, body mass,body mass index(BMI),waist circumference,blood pressure,blood glucose,blood lipids such as triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C), etc.. TCM constitution types of the MS patients were classified according to Self-rating Scale for Traditional Chinese Medicine Constitution Classification and Discrimination. Results (1)In the 328 cases,the patients with increased TG or having treated with lipid-lowering therapy,the patients complicated with increased blood pressure or having treated with antihypertensive therapy,and the patients with the previous diagnosis of hypertension were dominant,accounted for 41 cases(12.50%).(2)Bias constitution was predominant, showing in 308 cases and accounting for 93.90%. Phlegm-damp constitution was mostly commonly seen in the bias constitution, accounted for 78 cases(23.78%). And then the damp-heat constitution, Qi stagnation constitution, complicated constitution, Qi deficiency constitution, yang deficiency constitution, blood-stasis constitution, yin deficiency constitution and specific constitution came next orderly. Twenty patients had the harmony constitution, accounting for 6.10%. (3)MS patients with phlegm-damp constitution had higher body mass and BMI than the patients with harmony constitution, the difference being significant (P < 0.05). The differences of TG were significant between the phlegm-damp constitution and the specific constitution(P <0.05). Conclusion The included MS patients have typical clinical manifestations, and their TCM constitution types are commonly seen as phlegm-damp constitution,damp-heat constitution,and Qi stagnation constitution. The results of constitution discrimination will supply evidence for the individualized therapy for the treatment and rehabilitation of MS patients.

Objective To explore the role of P-glycoprotein(P-gp)on cellular uptake and metabolism in the transmembrane transport of quercitrin.Methods Caco-2 cell monolayer and P-gp inhibitor Cyclosporin A(CysA)were used in the study.Quercitrin, quercetin,isorhamnetin and tamarixetin were determined by LC-MS to study cellular uptake and metabolism of quercitrin on Caco-2 cells.Results Uptake of quercitrin by Caco-2 cells:in different concentration groups of quercitrin coincubating with and without Cy?sA,intracellular accumulation presented the following characteristics:the amount of quercitrin first rose,reached the peak in 60 min and then declined to a steady-state in 120 min.And meanwhile there were significant differences between the two different processing groups incubating with and without CysA(P<0.05);quercetin was detected in all groups(3.0,9.0 and 27.0 mg/L).But in the higher concentration groups incubating with and without CysA,the intracellular quercetin presented a characteristics similar to its original glycosides and showed a significant difference(P<0.05),while the other groups showed no concentration-and time-dependence.At the same time,isorhamnetin and tamarixetin were detected in two higher concentration groups incubating with and without CysA, which showed the trend similar to the original glycosides but no significant difference was obtained between the two processing groups(P>0.05).Isorhamnetin and tamarixetin were not detected in the low and middle concentration groups.Transmembrane transport:on the basal lateral of all groups,the content of the quercitrin in 150 min incubation time showed a trend of continuous rise,and there was no significant difference between the two processing groups.Quercetin,isorhamnetin and tamarixetin were not detected.Conclu?sion Intact quercitrin could be absorbed into the Caco-2 cells and transported across the Caco-2 cell monolayer,and suffered a series of further metabolism in the Caco-2 cells and the basal side of Caco-2 cell monolayer,leading to different characteristics between intra?cellular accumulation and transmembrane transport.P-gp reduces the transmembrane transport of quercitrin by its efflux function,but did not involved in quercitrin metabolism.